The epidemic of Acquired Immune Deficiency Syndrome (AIDS) confronts the rehabilitation professional with a number of concerns. This paper reviews literature on the diagnosis, epidemiological factors, psychosocial elements, medical intervention of AIDS, and rehabilitation issues involved in serving AIDS patients. (JDD)

Examines feasibility of palliative approach for all patients, showing reasonable people may refuse even the most exemplary care for themselves or an incompetent relative. Medical realities and alleviation of pointless suffering necessitate that policymakers consider other options, including "active" euthanasia, consistent with patient…

The effects of scheduled intern rotations on the cost and quality of inpatient care at a teaching hospital were studied for 1,705 rotation patients and 3,141 no-rotation patients. Systematic discontinuity of scheduled rotations may be a source of increased health care costs at teaching hospitals. (SLD)

Examines whether elderly individuals issuing advance directives for health care were more likely to have their wishes understood by designated surrogates than elderly folks who had not given such a directive. The mere completion of a directive did not guarantee the decision maker's awareness of the older person's wishes. (RJM)

This response to a description of a psychotropic drug review process, TAPER, suggests that the data supporting the reported low rate and dosage level of psychotropic drug use resulting from the process were misleading and inaccurate. Implications of such a drug review process for facilities serving people with developmental disabilities are drawn.…

A study modeled the financial impact of the Medicare fee schedule on an anesthesiology department in two different scenarios, one using actual-time units through the five-year transition period and the other using average-time units. One year's actual payments and frequencies for services billed provided baseline data. (Author/MSE)

Discusses the career of David Baines, an American Indian doctor who successfully integrates traditional and modern medicine. Describes problems faced by American Indian doctors, the tremendous amount of work involved in medical training, and problems associated with working in rural areas and trying to straddle two opposing cultures when…

This article reviews neuroimaging techniques such as cranial ultrasound, computed tomography scanning, and magnetic resonance imaging. Their roles in the care of children with neurodevelopmental disabilities include identification of high-risk infants, establishment of the diagnosis and prognosis in affected children, and enhancement of discussion…

A nationwide survey of 84 child protection workers found that 92 percent of the counties represented had a problem meeting their medical needs and would be willing to hire a physician assistant as medical consultant. Needs most commonly identified were providing parent education, interviewing, and interpreting medical information to a…

Describes an approach to combining health and social work services in a small community in a nontraditional setting through the use of a multidisciplinary student training project. Discusses professional relationships, service provision, patient use of services, and patient satisfaction. Provides suggestions for the establishment of similar…

This article reviews studies evaluating neurocognitive changes following organ transplantation in pediatric end-stage renal and liver disease. Findings suggest possible neurocognitive benefits associated with organ transplantation. Recommendations are made for methodological improvements in future research. (DB)

This overview of traumatic brain injuries discusses (1) incidence and prevalence; (2) characteristics; (3) the recovery process; and (4) educational/medical assessment, including premorbid functioning, current functioning, educationally relevant medical issues, and amount and type of family support. (JDD)

A study of 30 girls (ages 6-16) and their adult guardians found the majority of adults were inadequately prepared for their children's anogenital exams and reported that they receive no exam information prior to the clinic visit. Most children knew little about the exam's sensory or procedural aspects. (Author/CR)

Information available so far indicates that children in managed care arrangements are less likely to be seen by pediatric specialists and that families and providers are less satisfied under managed care. In spite of these drawbacks, the managed care approach, modified appropriately, offers new opportunities to provide high-quality medical care…

Surveyed 196 medical college seniors about changes in the health-care system. Of the respondents, 79% believed that cost reduction rather than quality of care is the primary consideration behind recent changes, and 78% thought that managed-care organizations hamper physician ability in rendering optimal care. Discusses implications for curricular…