A study of Dalhousie University (Nova Scotia) medical school primary care residency graduates (n=200) and other specialty graduates (n=371) suggests that the institution's policy of requiring first-year residencies in small community health services may cause more graduates, both primary care and specialists, to choose rural practice locations.…

A study compared characteristics of the 25 medical schools producing the lowest percentage of primary care physicians with the 25 producing the largest percentage. Results indicate differences in school commitment to primary care education, research programs, and clinical environments supporting required clerkships, suggesting educational…

A survey of faculty (n=223) and students (n=157) in two different curriculum tracks (problem-based/student-centered primary care vs. regular) at one medical school gathered opinions on the methods and criteria of student evaluation. Differences occurred primarily in the perceptions of first- and second-year students in the problem-based…

A survey of 468 practicing family physicians, general internists, and pediatricians examined relationships between educational debt and specialty choice, practice location choice, and types of patients treated. Results indicate that the high costs of medical training promoted rural work and care for poor patients by prompting generalists to commit…

Develops a framework for identifying community long-term care program and policy features that support or hinder client autonomy. Offers a contextual approach for understanding individual autonomy and discusses its relevance to community long-term care. Illustrates how current financing, organization, and delivery of care provide clients with…

A survey of 57 dental school deans concerning current and ideal curricular emphases in 33 topic areas identified three that were rated highly as ideals: health promotion/disease prevention; primary care; and effective patient-provider relationships/communication. The most significant barrier to reform was an already crowded curriculum. Deans…

Implementation studies are recommended to assess the feasibility and effectiveness in real-life of programmes which have been tested in randomized controlled trials (RCTs). We report on an implementation study of two evidence-based exercise and health education programmes for older adults with osteoarthritis (OA) of the knee or hip. Three types of…

More than 485,000 low-birth-weight, premature babies are born in the U.S. each year. The increase in preterm births since 1990 may be due to assisted pregnancies and births to older mothers. Although their survival rates are improving, many premature infants experience long-lasting developmental and behavioral problems. The author describes recent…

In 1993 the Massachusetts Department of Public Health (MDPH) began defining essential components of school health service programs, consistent with the public health model. The MDPH designed and funded the Enhanced School Health Service Programs to develop 4 core components of local school health services: (a) strengthening the administrative…

Objective: Studies spanning nearly 4 decades demonstrate that doctors ignore or dismiss many patient bids for discussion of psychosocial topics. We sought to understand characteristics of doctors, patients, and visits in which this occurs. Methods: Reanalysis of 167 audiotapes from 2 studies of parent-doctor communication in a pediatric residents'…

This publication is a compilation of papers presented at an April 1994 workshop sponsored by the National Center for Education in Maternal and Child Health and the Bureau-funded Johns Hopkins Child and Adolescent Health Policy Center (CAHPC). The papers are as follows: (1) "Defining the Issues and Planning for Change: Health Care Systems,…

This report is the result of a study by a committee charged with developing strategies for financing graduate medical education (GME) for primary care (general internal medicine, general pediatrics, and family practice) practitioners in ambulatory settings. Historically, systems of financing for most physicians in GME have favored inpatient and…

This book brings together 24 contributions (from 13 European countries) about the role of self-help in the overall pattern of health care, dealing with both the practical and the theoretical: (1) "A Reorientation of Health Care?" (Ilona Kickbusch and Stephen Hatch); (2) "Self-help Groups in Primary Health Care" (David…

A method for evaluating physicians' practice behavior after undertaking continuing medical education (CME) conducted by the American College of Cardiology (ACC) was developed and tested during 1983-1985. The literature on CME effectiveness and physician behavior change was reviewed. Physicians who were trained interviewers conducted telephone…

This report is submitted to accompany a bill reauthorizing the Stewart B. McKinney Homeless Assistance Act programs within the jurisdiction of the Committee. In the report, the Committee recommends that the bill be passed with a suggested amendment in the nature of a substitute The report is divided into six parts. Part I,…