Examines cultural factors associated with pregnancy among Hispanic adolescents, highlighting policy areas within the health care delivery system that must be addressed. The paper discusses migratory patterns and service needs, acculturation and pregnancy, valuing of children, access to health services, the role of the health practitioner, and…

This study examined self-assessments of 40 medical residents and competence expectations of 4 primary care internal medicine faculty and 10 medical specialty faculty. Specialty faculty members reported higher expectations for diagnostic performance than did faculty in primary care. Involvement of residents and faculty members in developing…

The primary care clerkship at George Washington University (District of Columbia) medical school, the only required ambulatory care experience in the curriculum, is described. Topics discussed include the interdisciplinary structure of the program, its goals, curriculum and student evaluation, and challenges faced in implementation (faculty,…

Early literacy experiences play an important role in later literacy skills and school achievement. Communities offer early literacy experiences in a variety of venues to meet the diverse needs of families. The author of this article provides four vignettes illustrating community-based early literacy activities: (1) private group classes such as…

This paper explores the broad definition of health in the rural context and relates it to policy, practice, and pedagogical challenges in providing access to services in rural areas. Historically, policy, practice, and teaching institutions have supported a dependency model for health service delivery, forcing rural communities to rely on…

This brochure describes the meeting of 63 representatives from the American Academy of Pediatrics, Washington Business Group on Health, Maternal and Child Health Bureau, and the education community convened to develop an action plan for American health care that would be responsive to children's needs. Highlighted problems included the lack of…

Health promotion redirects thinking about health by: reasserting its social and political aspects; ensuring the people the power to define their own health concerns; and placing health more clearly in the context of other aims in life. This compilation of 41 articles in 8 sections attempts to document this process of redirection of thought. The…

Least-cost health strategies designed to attack the world's leading causes of unnecessary death are explored. Section 1 emphasizes the value of primary health-care procedures--midwifery, maternal education on breastfeeding and weaning, vaccinations, oral rehydration of victims of diarrhea, and antibiotics against respiratory infections--in…

Health care and social services in Poland are affected by the culture context of geography, demography, and culturally induced expansion in historical periods. Health and financing of health services are issues with significant political ramifications and, despite egalitarian ideology, there is differential access to care and services. The…

Emphasizing primary care, this handbook focuses on the application of specific types of telecommunications technology to the process of information exchange within a rural health care system. Its purpose is to provide guidance to health care planners who want to consider the potential of telecommunications technology for improving quality,…

Recognizing the needs, deficiencies, and diversity of school health services is prerequisite to any analysis of need. More uniform programs and more equitable access for all school children to whatever minimal standard of health services should be provided: periodic examination, some limited medical care on the school grounds, intensive health…

The electives program at the University of Missouri at Kansas City School of Medicine was evaluated. The program provides opportunities for learning in community hospitals, physicians' offices and clinics, the main campus of the university, and other health-resources locations in western Missouri. The School of Medicine emphasizes primary care in…

Project objectives were to train 10 nurses from hospitals in the Four Corners Area in rural critical care nursing, to have a training director organize and coordinate the project, and to utilize the replacement nurse concept. The course curriculum was determined through a needs assessment survey conducted by a team of health professionals from…

Discussed are the issues now emerging that seem likely to dominate thinking, planning, and decision-making in the United States and elsewhere during the next decade. These include campus unrest, China as a world economic force, controlling health-care, birth defects, role of the computer in education, and human language/computer language. (RM)

Starting Early Starting Smart (SESS) is an early childhood public/private initiative designed to identify new, empirical knowledge about the effectiveness of integrating substance abuse prevention, addictions treatment, and mental health services with primary health care and childcare service settings (e.g., Head Start, day care, preschool) to…