Review of charts for 141 children who had undergone both a screening interview by an emergency department physician and an investigative interview for child sexual abuse evaluation found that perpetrator identification obtained during emergency department screening interviews usually agreed with information obtained at the subsequent investigative…

This paper describes financing, utilization, and outcomes of the Developmental Disabilities Center at Morristown (New Jersey) Memorial Hospital, to demonstrate the cost effectiveness of a managed health care program for individuals with mental retardation. The paper discusses costs, funding sources, hospital financing, resource allocation,…

Examines the effectiveness of special care units (SCUs) for Alzheimer's disease by summarizing published studies on SCUs. Presents and discusses the many potential sources of bias that pose special problems for SCUs for Alzheimer's disease research. Proposes strategies for conducting and interpreting future outcome studies in this research…

Organizational aspects of the Shock Trauma Institute at Loyola University Medical Center (Illinois) are described. The philosophies and conditions that helped determine the institute's organizational structure and success are analyzed, and the institute's role as a multidisciplinary research program is discussed. Structures of the clinical,…

This study found chronic regurgitation in 23 of 220 institutionalized adults with severe mental retardation. A high prevalence of dysphagia and gastroesophageal abnormalities was found, suggesting the importance of full evaluation and treatment prior to a diagnosis of rumination in this population. (Author/DB)

Scientific and technological advances affecting dental education in the near future are examined, including the growing role of saliva in diagnosis, direct imaging methods, biomaterials research, computer-aided design and manufacturing, molecular biology, and new restorative dentistry. It is argued that dentistry should be a fully recognized…

At Case Western University (Ohio), medical students critically analyze the quality and cost of asthma care in the community by studying patients in primary care practices. Each writes a case report, listing all medical charges and comparing them with guidelines for asthma care. Several recommendations for improved care have emerged. (MSE)

Pediatricians (n=342) responding to a survey reported that they nearly all routinely performed some type of developmental screening; most recommended more training in developmental/behavioral pediatrics in residency programs; and 83% were aware of Public Law 99-457, but less than half were familiar with all of its provisions. (Author/JDD)

The Harvard University Medical School (Massachusetts) and a community health maintenance organization (HMO) have formed the first medical school department to be based in a freestanding HMO, replicating the conventional teaching hospital clinical teaching model in a managed care situation. The model is seen as potentially transforming medical…

This article discusses ethical questions in providing prenatal services, including testing and genetic engineering, and medical interventions with neonates and other very young children who have severe disabilities. It explores ways to enhance ethical decision making, including recruitment for multidisciplinary teams or other committees of adults…

Financial pressures are forcing the closure of some teaching hospitals and retrenchment using such strategies as development of ambulatory care and satellite facilities, merging with or acquiring other hospitals, and shortening patient hospital stays. A table lists revenues and profit margins for the 20 largest university-owned teaching hospitals.…

Answers child care center directors' questions concerning the use of the Haemophilus influenza type b (Hib) vaccine and use of over-the-counter medication with children in child care. (BB)

The following essential elements of programs that prepare physicians to care for at-risk children effectively are described: (1) active participation in children's care; (2) effective service programs for learning; (3) comprehensive, multidisciplinary, flexible, and intensive programs; and (4) program evaluation. The policy implications in…

This study compared 187 patients discharged from a Veterans Administration hospital rehabilitation unit with 215 discharges that occurred following implementation of a prospective payment system. There were no significant differences in demographics, self-care ability, or readmissions. Length of stay and referrals for home health care decreased,…

This paper discusses issues related to educating children dependent on medical technology. It examines the movement toward greater normalization for these children, the use of transdisciplinary teams to develop specific plans addressing the students' unique health care and educational needs, and possible curricular and classroom accommodations.…