HE4--a novel promising serum marker in the diagnosis of ovarian carcinoma.

Biomarkers have a wide range of applications in the management of several cancers. To date serum markers have been the most extensively used biomarkers in everyday practice but few markers are elevated in preclinical or premalignant disease, limiting their importance for estimating risk or for screening. Human epididymis protein-4 (HE4) is a novel serum marker which is more sensitive in the prediction of risk of ovarian malignancy than CA125 alone in patients with a pelvic mass. HE4 in combination with CA125 appears to be an effective tool for the early detection of recurrence or monitoring the response to therapy. Risk of Ovarian Malignancy Algorithm, utilizing the dual marker combination of HE4 and CA125, can be used to stratify both postmenopausal and premenopausal women into high- and low-risk groups, allowing for an effective triage of women to appropriate institutions for their care. A review of HE4 and its feasibility as a novel diagnostic tool in the management of epithelial ovarian cancer is presented.

Self-assessment in clinical health psychology: a model for ethical expansion of practice.

Society expects autonomous professions to ensure the competency of it practitioners, and professions should facilitate the continuing education and training of its members. Given the shift from psychology as a mental health profession to that of a health profession, the authors propose a self-assessment model for the individual practitioner to gauge his or her readiness to provide professional service in expanded areas of practice. This model could also be useful to the American Psychological Association, state psychological associations, and other purveyors of continuing education programs in systematically developing postgraduate experiences. A template for self-assessment that reflects well-accepted core domains of knowledge and skills is presented.

Empowerment through giving symptoms voice.

This paper takes the perspective that physical and behavioral symptoms can be viewed as a form of mind-body communication. If the symptoms are listened to and "given voice," they can point the way to addressing imbalances influencing the development of the symptoms or to examining factors that can empower clients to heal. The author contends that women's traditional gender socialization may play a role in developing symptomatic bodily expression. It is proposed that hypnosis provides a suitable method for hearing and translating the mind-body communication. The application of hypnotic techniques is illustrated through two case examples.