Too many fits

Continuing seizures for the chronic patient with epilepsy require careful assessment. In practice, attention to unsatisfactory drug therapy compounded by poor compliance is most rewarding. Reappraisal of the psychological aspects in the widest sense can be revealing and new diagnostic and therapeutic possibilities can be uncovered.     

If,when, and how to discuss available abortion services in the primary care setting

Many women prefer to receive abortion care with their primary care provider; yet, prior studies have suggested that women do not know or assume that their provider does not offer abortion care. Our objective was to explore if, when, and how women wish to be informed of available abortion services at their primary care clinics. We conducted interviews with 21 women at their primary care site during June–July 2014. Vignettes were used to identify clinic visit types in which information regarding abortion services would be welcome and appropriate and inappropriate ways for providers to inform patients of these services. All participants were open to provider-initiated discussion of available abortion services, particularly during women’s wellness exams or contraception visits. Themes associated with appropriate communication of abortion services included: 1) using sensitive language, 2) respect for and assessment of patient beliefs, and 3) contextualizing abortion services within reproductive health. Advantages to discussing available abortion services included strengthening the patient-provider relationship and improved awareness of the spectrum of services offered. Routine inclusion of abortion services counseling may help educate patients about available services, strengthen the patient-provider relationship, and reduce the stigma surrounding abortion care.     

District profile: the shoe fits at Northampton

An old county town that has retained its individuality through all the changes of the last three centuries, and is expanding vigorously to meet the challenge of the next--that is Northampton. The health services of the district reflect the town, and draw strength, as they always have done, from close links with the community they serve.