Rurals using new techniques to finance long-term care

As the population of rural America ages, rural hospitals are seeing opportunities for new revenue in long-term care. To meet those needs, they are turning to tax-exempt revenue bonds, something they rarely used in the past, and private venture capital, an entirely new wrinkle.     

A six-year follow-up study of childhood behavior problems

In order to study the outcome of childhood behavior problems and to investigate relationships between those behavior problems and mental health problems in later years, a survey which was conducted in 1977 was repeated after six years. Subjects were randomly selected children aged from three to seven years living in Bunkyo-ku in Tokyo in 1977. Out of 279 children, responses to the questionnaire were obtained for 201 children, with 39 refusing to co-operate and 39 having left the area. The main results were as follows: 1. Comparison of prevalence rates of individual behavior problems occurring in early childhood (from 3 to 7 years old), showed that behaviors such as overactivity, "difficult to control", persistence, stubbornness and poor relations with unfamiliar persons decreased rapidly with age. On the other hand, hypoactivity, withdrawal and shyness increased. For problems occurring in late childhood (from 9 to 13 years old), the prevalence of poor concentration and passive behavior problems increased with age, while aggressive behaviors decreased. Behaviors such as thumb-sucking, nail-biting, bed-wetting and tics decreased. 2. Over the six years of this study, many behavior problems in areas of activity, mood, volition, human relations and abnormal symptoms showed significant persistence, although the degree of the persistence was not very strong. 3. Significant relationships between behavior problems observed at age three to seven years and mental health problems such as refusal to attend school and antisocial behaviors after six years were not seen.     

Sexual dysfunction in male and female patients with epilepsy: A study of 86 outpatients

Sexual dysfunction is a well-known complication of chronic somatic illness. Eighty-six consecutive epileptic outpatients, 38 men and 48 women, without accompanying disorders, were studied. The frequency and symptoms of sexual dysfunction were compared with results from previous studies using identical sexological methodology. The previous studies were of diabetic patients and healthy controls. Eight percent of the epileptic men reported a sexual dysfunction compared to 44% of the diabetics and 13% of the controls. Epileptic women, diabetic women, and controls showed no significant differences in sexual dysfunction (29%, 28%, and 25%, respectively). In both sexes, the sexual function measured by frequencies of coitus and masturbation was normal. Most patients had good control of epileptic attacks on a treatment of monotherapy. Hormonal status was generally within normal limits in both men and women; only a few minor differences were found and they showed no correlation with sexual dysfunction. Psychologically and socially the patients did not differ appreciably from normals, and they exhibited a high degree of disease acceptance. This study, using a biopsychosocial approach in understanding sexual dysfunctions, is in contrast with previous, mainly uncontrolled, studies of epileptic patients that reported high frequencies of hyposexuality in males. We conclude that epilepsy does not necessarily increase the risk of sexual dysfunction in male or female.     

Tumult, triumphs and turning points. Year of cuts, gains and reform proposals sets the stage for '91

It was a year of decisive wins and losses, a year that for many healthcare organizations signaled a turning point. The resignation of AHA President Carol McCarthy, a Supreme Court decision on Medicaid payments and myriad proposals for healthcare reform were among the events setting the stage for 1991.     

Reprieve ends; hospital margins slide in 1989 as costs climb, debt bill grows

Hospital profitability dipped once again in 1989 after a one-year reprieve from a pattern of sinking margins that has developed since 1985, according to an annual study published by Deloitte & Touche and Health Care Investment Analysts.