Objective: This report describes an educational intervention designed to improve psychiatry residents' inpatient charting skills. Methods: The residency training committee formed a multidisciplinary team to study the problem by using quality improvement principles. The team hypothesized that residents' charting would improve with education about…

In the selective contracting era, consumer choice has generally been absent in most state Medicaid programs, including California's (called Medi-Cal). In a setting where beneficiary exit is not a threat, a large payer may have both the incentives and the ability to exercise undue market power, potentially exposing an already vulnerable population…

Context: Physician assistants (PAs) and nurse practitioners (NPs) have licensure to practice in all states and they have prescriptive authority in 47 and 40 states, respectively. However, there have been no published studies from a national standpoint comparing urban and rural settings. Purpose: The objective of this study was to describe the…

Objective: To investigate the views and experiences of parents whose children have rampant tooth decay. Methods: In-depth, semi-structured interviews were carried out with 19 parents of varied age and social background whose children had been referred to Dundee Dental Hospital for assessment for dental extractions. Participants were encouraged to…

This booklet focuses on classic autism, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome, with brief descriptions of Rett syndrome and childhood disintegrative disorder. The booklet describes possible indicators of autism spectrum disorders (ASD), their diagnosis, available aids, treatment options, adults…

Randomized trial evidence and expert guidelines are mixed regarding the value of combined pharmacotherapy and psychotherapy as initial treatment for depression. This study describes long-term results of a randomized trial (N = 393) evaluating telephone-based cognitive-behavioral therapy (CBT) plus care management for primary care patients…

Aim: Recently, attention has focused on the health inequalities experienced by people with intellectual disabilities (ID) when compared with the general population. To inform policies aimed at equalizing health opportunities, comparable evidence is needed about the aspects of their health that may be amenable to intervention. Method: Applying the…

The Subcommittee met to examine recent new standards of the Accreditation Council for Graduate Medical Education (ACGME) that require training programs in obstetrics and gynecology to perform and teach abortion techniques, as well as the impact of these standards on program accreditation, and the programs' and students' consequent eligibility for…

Although many battered women seek help from their family physicians as outpatients, rates of current and lifetime victimization among outpatient female patients have not been well studied. This study tested two hypotheses regarding whether battered women presented to the clinic in a different manner than did nonbattered women. First, within the…

The first section of this report on childhood tuberculosis in developed and developing countries discusses the epidemiology of tuberculosis in children. Information is presented on: (1) sources and prevalence of infection; (2) risks, frequency, and types of tuberculosis; (3) mortality rates; and (4) the relation of poverty and AIDS to…

The report describes services, administration, and future directions of the Children's Special Health Care Services program, part of the Michigan Department of Public Health. Division programs are carried out at local, regional, and state levels and provide: preventive services (through generic and newborn screening services and neonatal intensive…

The potential impact of the increasing supply of physicians on physician behavior, the cost of medical services, and access to services is addressed in detail in this final research report. Econometric modeling and analyses of economic activity within the health sector were undertaken. An eight equation model of the hospital and physician sectors…

One approach to field theory in argumentation begins with a description of argumentation and, by identifying similarities or regularities in discursive practice, attempts to induce the nature and characteristics of a field. The controversy surrounding the use of Laetrile, a proposed cancer treatment, provides an example of this approach. Assuming…

Joseph Dorsey describes the development of the Harvard Medical School service program now serving 40,000 members in two health centers. Planning considerations for developing the primary care residency are included. Arnold Relman discusses the role of internal medicine and pediatrics in training primary care physicians noting subspecialization…