Gender- and race-based standards of competence: Lower minimum standards but higher ability standards for devalued groups.

Cultural Competence Standards

We know that cultural values and traditions offer special strengths that should help guide health care messages and treatments. The Substance Abuse and Mental Health Services Administration (SAMHSA) and its Center for Mental Health Services (CMHS) believe that mental health services often are more effective when they are provided within the most relevant and meaningful cultural, gender-sensitiv...

Ethical Standards for Groups

There has been consider able discussion about the ethical aspects of the group movement, which includes a variety of groups going under such names as T-groups, sensitivity groups and encounter groups. However, little if any progress has been made in developing guidelines or standards. There are at least two reasons for this lack of progress. One is that the problem is an exceedingly difficult o...

Guidelines: minimum standards, gold standards, or ideals for practice?

I have a spectrum of reactions to guidelines. Most impress me with the sheer volume of material that has been reviewed. Some show great thoughtfulness & practicality, such as the “Guidelines for Management of Valvular Heart Disease” [1]. Others contain recommendations without basis in trial data, such as the recent PCI guideline suggestion that post-PCI CK-MB elevations might require additional...

Minimum Standards for Church Archives

Minimum standards of anorectal manometry.

Functional disorders of the anus and rectum affect 10–20% of the population. Tests of anorectal function can provide useful information regarding the pathophysiology of disorders that affect continence and defecation or those that cause anorectal pain. Currently, several tests are available for evaluating anorectal function (Table 1). Often, they complement each other, but among the various tes...