Factitious wound infections in an altruistic living liver donor.

We report a case of recurrent factitious wound infections in an altruistic living liver donor. Costs for the infections after donation were billed to the recipient, creating a threat to the recipient's lifetime benefits. This case illustrates the importance of obtaining previous medical records on living donors.

Obesity in America: implications for clinical and health psychologists.

The number of individuals classified as overweight and obese is increasing at alarming rates and these conditions are associated with numerous psychological and physiological health problems. Within this epidemic, there is an increasing need and demand for psychologists and other mental health professionals to participate in the care of patients with obesity, both in assessment and treatment domains. The current paper provides a review of the status of the obesity epidemic, including psychological comorbidities and treatment approaches. Throughout this review, we highlight and discuss the important roles and impact psychologists can have. These roles include serving as members of multidisciplinary obesity treatment programs, conducting assessments for bariatric surgery, and treating related psychiatric disorders, such as depression and disordered eating. Other considerations, such as weight gain associated with psychiatric medications, and directions for future involvement of psychologists in addressing the obesity epidemic are also discussed.

Psychosocial evaluation of bariatric surgery candidates: a survey of present practices.

OBJECTIVE: Successful outcome for bariatric surgery is largely dependent on patients' ability to adhere to postoperative behavior changes. A thorough psychological evaluation is often required before patients' approval for surgery. In addition to a standard psychiatric interview, assessment of behavioral components specific to this surgery seems indicated. No uniform guidelines exist on how to conduct such an evaluation. This survey was designed to collect information on the level of involvement of mental health professionals with bariatric surgery programs and their approach to evaluating bariatric surgery candidates. METHODS: Surveys about psychological evaluation practices were mailed to 188 bariatric surgery programs. Eighty-one surveys were returned. RESULTS: Eighty-eight percent of programs require patients to undergo a psychological evaluation and almost half require formal standardized psychological assessment. Current illicit drug use, active symptoms of schizophrenia, severe mental retardation, and lack of knowledge about the surgery were the most commonly cited contraindications, preventing patients from gaining approval for surgery. DISCUSSION: The majority of programs use psychological evaluations; however, the exclusion criteria for surgery vary greatly. Establishing uniform guidelines for the screening of bariatric surgery candidates is necessary. Suggestions on how to begin this process are provided. More research about behavioral and cognitive predictors of postsurgical success is needed.

Body image and attitude toward obesity in an historically black university.

INTRODUCTION: The obesity epidemic is a major problem in the United States, particularly among black women. Body image and attitudes toward obesity are important areas to understand and address in any comprehensive approach to this epidemic. METHODS: From an initial evaluation of 200 college students (25 male and 25 female freshmen, sophomores, juniors and seniors each) attending an historically black university, we selected those students who identified themselves as black for data analysis (n = 191). All students underwent height and weight measurement from which body mass index (BMI) was calculated. Each student answered two questions related to nine silhouettes for each sex that progressively moved from extreme thinness to extreme obesity. Also, each student answered 20 questions describing attitudes about obesity. RESULTS: Black college students placed between the 62nd and 72nd percentiles of national BMI data for adolescents. Black female students were more likely than their black male counterparts to be obese. BMI did not vary by sex or grade level. Students of both sexes generally preferred "trim" silhouettes with the caveat that students with BMIs <25 kg/m2 preferred smaller silhouettes than did students with BMIs > or =25 kg/m2. BMI and sex did not favor any particular set of attitudes toward obesity. CONCLUSION: Black male and female college students from an historically black university were largely in the "normal" range of BMI percentiles for sex and age. Our black female students were more likely to be obese than our black male students. Our findings suggest that young black women are tolerant of a variety of body sizes. Based on findings from our Attitudes Toward Obese Persons scale, body size sense of self and sex do not influence attitudes toward obese persons. Further studies are needed.

Psychological assessment and care of organ transplant patients.

Organ transplant has been developed in animal models over the past 100 years. The major limiting factor in transplant medicine is the shortage of donor organs. This shortage creates pressure for fair and efficient allocation of organs, with expectations that those involved in transplantation will strive to achieve optimal outcomes and ensure just access. This article reviews the major types of transplants and the illnesses and behavioral comorbidities that lead to these procedures, the psychological assessment of transplant candidates, the adaptive tasks required of the transplant recipient at various stages of the transplant process, and relevant psychological interventions. Liaison with others on the transplant team and ethical issues of concern to psychologists who work with transplant patients, including living organ donors, are also discussed. Finally, new developments in transplant and suggestions for future psychological research in organ transplant are presented.