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Infertility and its treatments can present highly complex medical and/or surgical problems accompanied by emotional turmoil for individuals, couples, and families. On a societal and global level, infertility treatments can include costly interventions that result in questions of priority, access, and payment. Infertility technologies also raise moral and ethical dilemmas in areas where the interventions have yet to be matched with shared ethical guidelines.

The purpose of this descriptive study is to examine quality of life issues in participants in a behavioral-medicine group (N = 24). Of the sample, 60% indicated current use of complementary therapies. Sexual functioning, a subscale of the quality-of-life measure, was positively correlated with length of time with HIV. CD4+ lymphocyte counts were not significantly correlated with quality of life (QOL). Viral load (VL) was positively correlated with the social-support subscale of the QOL scale. Use of body therapies (massage, acupuncture) was associated with social functioning and use of nutritional therapies was associated with mental health. Results of the study indicate that clinical interventions, including behavioral-medicine interventions and complementary therapies for persons with HIV/AIDS, can result in greater QOL.

Purpose: Delirium is a common and distressing syndrome seen in patients with advanced cancer. Behavioral manifestations of delirium, such as agitation, may result in medical intervention, stress to family caregivers, and inpatient hospice admission. The purpose of this study was to examine the frequency, characteristics, and presumed causes of delirium in patients with advanced cancer. Description of study: Records of all patients with cancer who were admitted to an inpatient hospice facility in 1995 were reviewed retrospectively (N = 210). Patients were classified as delirious based on the clinical judgment of the admitting physician. Results: Delirium was the third most common reason for admission (20%). Male gender (P = .04) and the presence of a primary or metastatic brain tumor (P = .03) were significant risk factors for delirium, while advanced age and primary or metastatic liver, lung, or bone cancer were not. Resolution of the agitation, the most disruptive symptom of delirium, occurred in 69% of patients before death or discharge. Clinical implications: Delirium is common in hospice patients with cancer and is an important cause of family distress and increased cost of care. The recognition of early clinical signs and predisposing factors should facilitate prompt diagnosis. Appropriate intervention is usually successful in alleviating the most distressing symptoms of delirium.

The authors of this descriptive study used Orem's Theory of Self-Care to assess perceived demand for or change in universal and health-deviation self-care activity and the degree of difficulty ascribed to meeting that demand. Perceived demand or change in self-care and difficulty in self-care were measured using the Self-Care Burden Scale ( Oberst, Hughes, Chang & McCubbin, 1991 ) and a structured interview. A convenience sample of 10 English or Spanish-speaking women with HIV infection utilizing a city hospital's outpatient immunodeficiency clinic were recruited. Of the health deviation selfcare items, home medical/nursing treatments, special diet, and obtaining resources were the most burdensome categories. Universal self-care tasks with the highest burden scores were caring for children, physical activity, and work