Economic concerns dominate hospital planning and policy decisions as hospitals seek to become more productive, competitive, and profitable. Quality care and public service may conflict with the profit-motivated business model. Nurse administrators will have to be politically astute to promote the integration of a professional model of service.…

The shift in emphasis to developing countries in the world perspective on the elderly is reflected in two Expert Committee Reports from the World Health Organization. Unless social policy can be designed to strengthen family support channels, new services will have to be instituted to supplement a decaying informal system. (Author/MLW)

The hemophilia community has been deeply affected by the catastrophe of AIDS (Acquired Immune Deficiency Syndrome). The use of blood products that had first restored the potential for normal survival now bring the threat of AIDS infection and fear and discrimination from others. Strong leadership has come from the National Hemophilia Foundation.…

Discusses changes in contemporary health care services for rural Appalachians. Examines how rural services are affected by rising costs, technological advancement, aging population, system reorganization, and physician and nurse shortages. Profiles Appalachian Rural Health Program and National Health Service Corps. (TES)

Describes collaborative efforts of New Jersey Department of Human Services child welfare division and the New Jersey Children's Hospital AIDS (Acquired Immune Deficiency Syndrome) Program to care for children with human immunodeficiency virus. Contends child welfare and health care communities have responsibility to provide comprehensive,…

A three-hour, two-stage workshop for staff nurses on providing education and psychological support to 148 patients who had abdominal surgery. After the workshop the patients used fewer sedatives or antiemetics, fewer hypnotics, and were discharged from the hospital on the average half a day sooner. (Author/BJV)

Bladder and bowel dysfunction is a common problem for children with myelomeningocele and related spinal-cord defects. The chronic medical and social effects of this problem necessitate a multifaceted and multidisciplinary approach. Reviewed are bladder and bowel anatomy and physiology, developmental concerns, treatment techniques, and psychosocial…

A national sample of medical students was surveyed to identify the ways the students obtained informed consent from their patients and to learn the students' views of certain issues concerning informed consent. All the students were less forthright about their status when given the opportunity to perform invasive procedures. (Author/MLW)

Explores relationship, if any, between level of regulatory intensity upon, and subsequent service delivery within, the hospital industry. Some service retrenchment may be desirable, particularly if fewer iatrogenic events occur. A look at prior efforts may prove beneficial before the United States initiates overall health care reform. (61…

Presents results of a three-state mailed survey that examined pre- and postadoptive service needs of 562 families who adopted children, most of whom had special needs, through public child welfare agencies. Financial and medical adoptive subsidies emerged as pivotal service needs. Counseling and education services and respite care were evaluated…

Children with neurological impairments are prone to develop serious infection with anaerobic bacteria. The most common anaerobic infections are decubitus ulcers; gastrostomy site wound infections; pulmonary infections (aspiration pneumonia, lung abscesses, and tracheitis); and chronic suppurative otitis media. The unique microbiology of each of…

This article identifies possible adverse effects of managed health care delivery systems on adults with mental retardation. It is noted that few primary care providers, the "gatekeepers" of such systems, have special training in examining and treating adults with mental retardation and that disincentives exist in such programs for…

Evaluates a social work program in a rural community designed to promote autonomous decision making by educating elderly people (n=32) about advance directives. Results revealed a continuum of willingness to address future decision making. The primacy of the family emerged throughout the study, suggesting that advance directives may be a family…

An Oregon program is described in which physicians in training are incorporated into a faculty private practice clinic. The model encourages efficiency, overhead control, and appropriate staffing; it also provides a useful learning experience in the ambulatory care setting and compensates faculty members for their additional time spent teaching.…

Conducted national survey of public opinion on age-based rationing of health care resources. Oversampled older adults to allow more precise comparisons of attitude by age cohort as well as by other demographic variables. Found majority of people accepted withholding of life-prolonging medical care to hopelessly ill patients, but few would…