Fatal postpartum spontaneous liver rupture: case report and literature review

Maternal hepatic rupture is a rare complication of pregnancy that can be fatal to both mother and child. This phenomenon is most often associated with preeclampsia/eclampsia and/or HELLP syndrome, which is defined by a collection of clinical features including hemolysis (H), elevated liver enzymes (EL), and a low platelet count (LP). These disease processes are typically identified and treated during pregnancy, often in the last trimester. The described case is unusual in that the decedent had no known history of preeclampsia/eclampsia or HELLP syndrome during this pregnancy, and she died suddenly several days postpartum of liver rupture with massive intraperitoneal hemorrhage following a routine cesarean section delivery and an uneventful hospital course. Similar cases are infrequent in the literature, which is reviewed in this report.     

Preference for the Diversity Policy Label Versus the Affirmative Action Policy Label

Study 1 assessed associations with the labels “diversity policy” (DP) and “affirmative action policy” (AAP) and perceptions of potential policy components. Student and community participants (N = 143) completed a survey assessing associations with one of the policy labels. Both policies evoked similar associations such as “race/minorities” and “equality/equal opportunity,” but the AAP was more often associated with “bias/inequality/discrimination,” “unfairness,” and “racism/prejudice.” When rating potential policy components, reverse discrimination was considered more likely under the AAP. In Study 2 we explored the evaluation of equivalent policy components associated with different policy labels. Student participants (N = 126) rated the policy labeled as the DP more favorably than the AAP. Both studies suggest more favorable attitudes toward the DP label.     

Exploratory trial of schema-focussed therapy in a forensic personality disordered population

The management of needs and risks in personality disordered offender populations has become a focus for health and criminal justice services in the UK. Recent studies demonstrate the effectiveness of schema focussed therapy (SFT) for patients with borderline personality disorder. This study was an exploratory trial of the feasibility of implementing SFT in a population of patients with personality disorder in a high secure hospital in England. Preliminary evaluations of the effects of SFT were conducted to investigate whether those receiving SFT demonstrated significant improvements on measures of anger, impulsiveness, schemata and interpersonal style. No significant effects were evident although there was a significant increase in defectiveness/shame schema in the SFT group. Lack of effectiveness of SFT is likely due to the preliminary nature of this study. Future trials of SFT need to ensure comprehensive therapist preparation, control of TAU, bigger samples, address attrition and provide more intensive therapy.