Do Sexually Oriented Massage Parlors Cluster in Specific Neighborhoods? A Spatial Analysis of Indoor Sex Work in Los Angeles and Orange Counties, California.

OBJECTIVE: Social determinants of health may be substantially affected by spatial factors, which together may explain the persistence of health inequities. Clustering of possible sources of negative health and social outcomes points to a spatial focus for future interventions. We analyzed the spatial clustering of sex work businesses in Southern California to examine where and why they cluster. We explored economic and legal factors as possible explanations of clustering. METHODS: We manually coded data from a website used by paying members to post reviews of female massage parlor workers. We identified clusters of sexually oriented massage parlor businesses using spatial autocorrelation tests. We conducted spatial regression using census tract data to identify predictors of clustering. RESULTS: A total of 889 venues were identified. Clusters of tracts having higher-than-expected numbers of sexually oriented massage parlors ("hot spots") were located outside downtowns. These hot spots were characterized by a higher proportion of adult males, a higher proportion of households below the federal poverty level, and a smaller average household size. CONCLUSION: Sexually oriented massage parlors in Los Angeles and Orange counties cluster in particular neighborhoods. More research is needed to ascertain the causal factors of such clusters and how interventions can be designed to leverage these spatial factors.

[Medical opinions in court--a challenge for communication between physicians and lawyers]. / Das medizinische Gutachten im Prozess--Kommunikationsprobleme zwischen Arzten und Juristen.

Medical opinions in court constitute a great challenge in regard to communication between physicians and lawyers. Considerable differences in their professional training and requirements frequently result in misunderstandings. Therefore physicians and lawyers need to learn more about each other and interact when evaluating opinions. A synergistic rather than a conflicting approach would help judges to find the happy medium between accepting medical reports unreservedly and coming to their own conclusions in more or less total disregard of the medical opinion presented in court. The expert, on the other hand, must ensure that the judge will understand the opinion as it was meant. Neither of them can call upon a translator.

Identifying ethicolegal and professional principles in reflexology.

Although few reflexologists are likely to be sued in the course of their professional practice, all practitioners owe their patients a duty of care and must work within the law. Ethical and legal responsibilities are integral to safe and effective practice. This paper will outline the major ethical and legal responsibilities owed by reflexologists to their patients.

Regulation of complementary/alternative medicine: a Canadian perspective.

Increased use of complementary/alternative medicine (CAM) therapies by Canadians combined with increasingly forceful lobbying from both practitioner groups and the public have made the regulation of CAM practitioners an important issue for Canadian policy makers. A variety of challenges (including regulatory structures that are difficult to change, fear of adding costs to an already under-funded healthcare system and the lack of internal cohesion of some CAM practitioner groups) are currently hindering attempts to implement new policy. However, an environment of health regulation review and renewal as well as public support for regulation may have created a window of opportunity for investigating policy options. Currently in Canada, health care providers are regulated by individual provinces. This means that although some CAM practitioners are either regulated (e.g. chiropractors) or not regulated (e.g. herbalists, homeopaths) in all provinces; others (e.g. naturopathic practitioners, acupuncture/TCM practitioners) are regulated in some provinces, but not others. Harmonization of regulations and scopes of practice for CAM practitioners across Canada is one of the biggest future challenges.

The future of reflexology.

It would have been difficult 30 years ago to foresee how great would be the grass roots response to reflexology. Over the past 5 years public and professional interest in Complementary and Alternative Medicine (CAM), its practice, future development and possible regulation have been of much concern in many quarters, not least among therapists themselves. The report of the House of Lords Select Committee on Science and Technology into Complementary and Alternative Medicine published in November 2000 made a number of recommendations likely to influence the social framework in which CAM has been practiced. This paper offers an appraisal of the practice of reflexology, its historic development, legal issues, scope and limitations of practice.