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This report summarizes the discussions at a workshop convened by the Forum on Adolescence of the Board on Children, Youth, and Families. The goal of the workshop was to provide an opportunity to learn about the work and preliminary findings of 16 projects and to review the knowledge base on the effectiveness of interventions designed to promote peaceful, respectful relations among youth of different ethnic groups. The report summarizes presentations at the workshop, reflecting the views and statements of those attending. Topics are grouped into these chapters: (1) "Improving Intergroup Relations among Youth"; (2) "This Rich and Growing Diversity"; (3) "The Meaning of Positive Intergroup Relations"; (4) "Youth and Identity Formation"; (5) "Schools and Their Influence"; (6) "The Power of Teachers"; (7) "Curricula as Tools"; (8) "School-Based Extracurricular Activities"; (9) "Peer Influence"; (10) "At Home: Parents and Their Influence"; (11) "In the Community"; (12) "The Role of Media and Technology"; and (13) "Toward a New Research Agenda: The Challenges." Two appendixes contain project descriptions and the workshop agenda. (Contains 25 references.) (SLD)

This background paper, prepared by two members of the Institute of Medicine's Committee on Strengthening the Geriatric Content of Medical Education, addresses the progress made in physicians' geriatric and gerontological education. The report appears in six chapters. After a brief introduction on health care reform and medical education, geriatric medicine and geriatricians are discussed in chapter 2. Some of the topics examined here include the historical development of geriatrics, physician certification, and the utilization and financing of health services. Chapter 3 analyzes past efforts to develop geriatrics and explores increases in geriatric faculty, geriatric fellowship programs and residencies, continuing medical education, and obstacles to the development of academic geriatrics. Chapter 4 assesses the demand for geriatricians and faculty, while in chapter 5, some strategies to strengthen physicians' geriatrics training are presented. Some of these strategies include revised financial policies, the revamping of service delivery, the strengthening of faculty development and academic programs, and recruiting and marketing ideas. The last chapter comments briefly on the 1993 Institute of Medicine Report. The recommendations made in the above report were grouped into five categories: (1) improved education in geriatrics; (2) leadership centers; (3) enhanced attractiveness of geriatrics; (4) revision in payment policies; and (5) research support. (RJM)

This pamphlet reprints the preface, contents, executive summary, and 27 recommendations from an extensive report on disability prevention issued by the Committee on a National Agenda for the Prevention of Disabilities. The summary notes that disability is a social, public health, and moral issue in addition to a medical issue. It cites statistics on the incidence of disabling conditions, and offers an overview of the conceptual framework of disability used in the report, composed of pathology, impairment, functional limitation, and disability. The summary then discusses prevention of disabilities across the life cycle: developmental disabilities, injury-related disabilities, disabilities associated with chronic disease and aging, and secondary conditions associated with disability. The 27 recommendations deal with the areas of: organization and coordination of a national program for the prevention of disability, surveillance, research, access to care and preventive services, and professional and public education. (JDD)

This report focuses on the 7.5 million children in the United States with diagnosable mental illnesses, examining developmental, behavioral and emotional disorders in this group. Progress being made toward understanding, preventing, and treating these disorders is documented, future directions for research are put forth, and critical resource requirements for advancing the field are delineated. Chapters include an overview, "Dimensions of Disorder,""Causes and Determinants,""Interventions for Childhood Mental Disorders,""Research Personnel and Infrastructure." Conclusions and recommendations are presented in terms of current knowledge/research progress and research needs/opportunities for the following areas: prevalence and costs; causes and determinants; and interventions. A national plan for National Institute for Mental Health-sponsored child and adolescent mental disorders research is proposed which would: (1) provide support and incentives for an expanded pool of research scientists; (2) provide increased support for individual project, program project, and center grants; (3) provide increased funding for research in such areas as epidemiology, diagnosis, treatment, prevention, neurosciences; and (4) provide for the establishment of an institute-wide consortium concerned with child and adolescent mental health research. (PB)

The under-representation of African American and Hispanic American students among high achievers on standardized tests, honors graduates of most colleges, and practitioners of mathematics and science professions is well-documented. This paper explores the extent to which the current educational reform movement is achieving the goal of substantially improving overall student achievement, especially high achievement, while also reducing achievement gaps among racial and ethnic groups. Neither high-stakes testing nor standards setting, both components of the modern systemic reform movement, is new, nor are the issues of testing and equity. The primary resource for tracking changes in students' academic performance is the National Assessment of Educational Progress (NAEP). Especially important to evaluating systemic reform efforts is a state NAEP testing program begun in 1990 which allows sophisticated and multidimensional comparisons of state academic performance. While NAEP data show that between 1971-88, the black-white achievement gap closed significantly, 1990s data show that the gaps are growing. There is little hard evidence that state systemic reform policies have had their intended effects. Results from the Texas Assessment of Academic Skills indicate a marked decrease in performance gaps of minority and white elementary students in recent years. (Contains 21 references.) (SM)

This report summarizes the presentations and discussion at a 1999 workshop entitled "Opportunities to Promote Child and Adolescent Development during the After-School Hours." This workshop brought together policy makers, researchers, and practitioners to examine research on the developmental needs of 5- to 14-year-olds and the types of after-school programs designed to promote their health and development; the workshop was intended as a forum for general discussion among various stakeholders. Topics addressed during the workshop include: (1) the impact of the policy environment on the demands for and design of after-school programs; (2) the need for after-school programs to meet developmental needs of children and adolescents; (3) the variation in scope, focus, and structure of after-school programs; (4) components of high-quality after-school programs; (5) examples of innovative approaches to after-school programming; (6) evaluating after-school programs; and (7) strategies for bridging research, policy, and practice with respect to the design and evaluation of after-school programs. The report concludes by noting that as more children and adolescents become involved in after-school programming, it will be increasingly useful for program organizers to attend to the issues addressed in this workshop. The workshop agenda and a list of participants are appended. (Contains 15 references.) (KB)

This report contains aggregate data on costs for all schools of medicine, osteopathy, dentistry, optometry, pharmacy, podiatry, veterinary medicine, and nursing, and the average education costs per student in these fields for a sample of schools during the 1972-73 academic year. Context for the study is provided by an appraisal of the educational institutions in the aggregate: (1) More than 1,600 schools in the United States provide education in the eight professions. (2) The schools spent more than $3 billion in the education of more than 30,000 students in 1972 but received less than 40% of their income from unrestricted education funds. (3) Two-thirds of all health professional students are in nursing. The other seven professions in 1973 graduated 22,900 students with the first professional degree. (4) Health professional schools vary greatly in their curricula, mixture of students, organization, and financial structure. (Author/MJM)

In February 1974, Parts I and II of a study of the Costs of Education in the Health Professions were submitted to the Congress and the Department of Health, Education and Welfare. The report was in response to a request contained in the Comprehensive Health Manpower and Training Act (Public Law 92-157). This volume, part III of the report, contains a detailed description of the methodology used in developing and analyzing the data contained in the study. Part III includes a description of the methodology used in the field study of 82 sampled schools and the process and results of the constructed costs modeling seminars held for the professions of medicine, dentistry, and veterinary medicine. Discussed in the two sections of the report are: (1) Education Costs and New Education Expenditures: The Program Cost Approach; and (2) The Constructed Cost Process. Attachments include statistical tables, sample questionnaires, seminar proceedings, and seminar participants. (Author/PG)

Graduate medical education (GME) in the military services was investigated with respect to the following concerns: the maximum capacity of each military medical department to conduct GME programs in its own hospital; how these programs affect the recruitment and retention of military physicians; and the optimal sizes of such programs. It is suggested that since the Navy and the Air Force are both approaching a new era in which physician shortages will no longer be a problem, the size of the GME programs--along with other physician manpower policies affecting recruitment, retention, promotion, and assignment of physicians--will have to be adjusted to function in a period of likely surpluses of physicians in many specialties. Based on site visits, it was concluded that all three military medical departments probably have expanded their GME programs to the maximum capacity (based on currently available facilities and resources, including staff and patients) or slightly in excess of maximum capacity in some cases. The optimal size of the GME program is a function of the availability of the numbers and kinds of military physicians needed. Since the pertinent circumstances of each of the three medical departments are different, no basis was seen for assuming that all three departments should be required to operate with the same proportion of their active duty medical officers in GME status. It is recommended that the Department of Defense withdraw its 1977 directive to the three military medical departments to limit the fraction of active duty physicians in military GME assignments to not more than 20 percent of the active duty physicians strength in 1985. Maintaining high quality military GME and scholarships is addressed. A bibliography and sample interview guides are appended. (SW)

The document contains the final report of a project to determine the factors that account for disproportionate representation of minority students in special education programs, especially programs for mentally retarded students; and to identify placement criteria for practices that do not affect minority students disproportionately. Chapter 1 looks at six potential causes of disproportionate placement of minorities in educable mentally retarded (EMR) programs: legal and administrative requirements, characteristics of students, quality of the instruction received, possible biases in the assessment process, characteristics of the home and family environment, and broader historical and cultural contexts. Chapter 2 describes characteristics of EMR students, then reviews the historical origins of special education in America with attention to the role of the standardized intelligence test for identification and placement of mentally retarded students. A third chapter is split into two sections--one on the issues surrounding the instruments that comprise a comprehensive battery for assessing a child who is unable to learn normally in the classroom, and the other on an ideal assessment process in which the comprehensive assessment would be embedded. Chapter 4 considers the components of effective education programs for EMR students and reviews three approaches to instruction (the separate class structure, the resource room, and the teacher consultant model). A final chapter lists recommendations for improvements in special education referral, assessment, and placement procedures and instructional practices. More than half the document is comprised of six background papers with the following titles and authors: "Biological and Social Factors Contributing to Mild Mental Retardation" (J. Shonkoff); "Classifying Mentally Retarded Students--A Review of Placement Practices in Special Education" (W. Bickel); "Testing in Educational Placement--Issues and Evidence" (J. Travers); "Effects of Special Education Placement on Educable Mentally Retarded Children" (K. Heller); "Some Potential Incentives of Special Education Funding Practices" (S. Magnetti); and "Patterns in Special Education Placement as Revealed by the OCR Survey" (J. Finn). (SB)

This report, written for the general public, presents the results of a 15-month study of the health-related effects of marijuana. The introduction describes the goals and procedure for the study, including the composition of the 22-member steering committee and its functions, and the sources of information used for the study, i.e., published scientific literature from 1975 forward, and information and opinions solicited from the public and professional groups. Chapter 1 reviews what is known about the chemistry and pharmacology of marijuana. Chapter 2 deals with the epidemiology and demography of the use of marijuana in the United States. The next three chapters discuss the effects of marijuana on cells, tissues, organs, and biological systems. Chapter 6 deals with behavioral and psychosocial effects. Chapter 7 discusses the present status of marijuana as a therapeutic agent. Chapter 8 describes and analyzes the federal research program on marijuana. A summary includes the principal findings and conclusions of the study, together with suggestions for future research. A glossary of terms for marijuana-related products and appendices with additional study information are included. (Author/MCF)

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 specialty education, making it difficult for primary care practitioner students to receive increased training in ambulatory settings. The study consisted of two meetings; at the first meeting, a program for a workshop was developed. At the second meeting, the workshop was implemented (April 18-19, 1989), with over 50 participants. The resulting recommendations are presented in the report's three chapters. The first, "Concerns about Primary Care Residency Training," outlines concerns about the production of primary care physicians to meet the nation's future requirements. Chapter 2 is titled "Costs and Revenues for Primary Care Residencies in Ambulatory Settings." Chapter 3, "Options and Recommendations for Financing Graduate Medical Education for Primary Care Physicians in Ambulatory Care Settings," lays out the committee's recommendations and discusses existing barriers to financing and criteria for evaluating policy options. Appendix A contains the workshop program and proceedings. Appendix B contains four additional papers commissioned by the group: "The Cost of Graduate Medical Education in Outpatient Settings" (Judith R. Lave); "Financing of Medical and Graduate Medical Education: Issues in Primary Care Education Support" (Ruth S. Hanft); "Financing Graduate Medical Education in Primary Care: Options for Change (Sandra C. Peinado and John M. Eisenberg); and "Financing Primary Care Residency Training: Examples and Lessons from Successful Programs" (Robert A. Walkington). (JB)

Results are presented of a study of nursing and nursing education that focused on the need for continued federal support of nursing education, ways to attract nurses to medically underserved areas, and approaches to encourage nurses to stay in the profession. Findings are presented on whether the aggregate supply of generalist nurses will be sufficient to meet future demand, and how changes that could occur in the health care system might affect demand. Attention is also directed to: how the current and future supply of nurses may be influenced by the costs of nursing education and the sources of education financing; and education for generalist positions in nursing. In addition, the supply and demand situation for nurses educationally prepared for advanced professional positions in nursing is examined. The influence of employer policies and practices in utilization of nursing resources on demand and supply is also addressed. Finally, areas in which further data and studies are needed to better monitor nursing supply and demand are identified. In addition to 21 recommendations, appendices include information on Nursing Training Act appropriations, state reports on nursing issues, certificates for specialist registered nurses, projections of registered nurse supply and requirements, and doctoral programs in nursing. (SW)

An examination of the changes over a ten-year period (from 1972 to 1982) in the number, distribution, and characteristics of Ph.D. faculty of clinical departments of medical schools is provided in this report. Trends in the training and research involvements of this group are stated with special emphasis on an analysis of the factors associated with the migration of basic scientists into clinical departments. Topics of this study include: (1) previous studies (identifying findings from related reports and meetings); (2) number and distribution of Ph.D. faculty in clinical departments (presenting data from FY 1972 and FY 1982); (3) a statistical profile of faculty members (including data on age, rank, salary, specialty fields, and research activity); (4) growth of basic science in clinical departments (examining the nature of investigation, expansion of clinical department, and the decline in research involvement); and (5) future outlook (projecting trends and addressing concerns). A list of 32 reference notes are provided and the seven appendices present the data in tabular form. (ML)

Designed to provide assistance in the assessment of the need for biomedical and behavioral research personnel, this report presents research findings related to specific medical careers. The review includes an examination of the system under which biomedical and behavioral scientists are trained for research careers and the United States government programs that support them. An introductory chapter provides an overview of the assessment procedures, findings, and recommendations. Specific study results are discussed for: (1) the clinical sciences (identifying trends in medical and dental schools); (2) basic biomedical sciences (including a survey of biotechnology firms and a market outlook for biomedical Ph.D.s); (3) behavioral sciences (explaining current supply/demand indicators); (4) health services research (providing definitions and examples of current health services research and identifying funding sources for this area); and (5) nursing research (examining doctoral programs and trends in nursing). A bibliography contains references from individual authors and also agency reports. Data from the assessment are provided in six appendices. (ML)

In response to the President's Office of Science and Technology Policy request to identify promising areas for U.S. research investment in science and technology, this report contains briefings by outstanding researchers in several fields of science. This volume is the fifth in a series of briefings which are used to anticipate important new avenues for research and to help establish priorities for funding. The papers focus on applications of science and technology which could result in economic and social benefits. Panel reports presented in this volume examine: (1) the science of interfaces and thin films (addressing research and management issues and applications for microelectronic technologies); (2) decision making and problem solving (explaining theories and extensions of theories related to problem solving); (3) protein structure and biological function (identifying research goals and summarizing technological advances); and (4) prevention and treatment of viral diseases (citing recent advances in molecular virology). This volume also includes a listing of the research briefing topics from previous reports. (ML)

In 1997, the Board on Children, Youth, and Families launched the Frontiers of Research on Children, Youth, and Families Initiative to highlight recent policy-relevant research on children, youth, and families conducted by young and mid-career researchers. The initiative sought to encourage more sustained interactions between these researchers and policy makers, and to foster the development of young scholars who work at the intersection of science and public policy. This pamphlet describes the six research projects of the nine scholars: (1) "Multigenerational Coresidence and Welfare Policy" (Rachel Gordon); (2) "Neighborhoods, Families, and Children: Implications for Policy and Practice" (Margaret Caughy, Patricia O'Campo, and Anne Brodsky); (3) "The Lessons of Energy Express in West Virginia in Connecting Policy and Community" (Gretchen Butera and Van Dempsey); (4) "Promoting Academic Success and Preventing Disruptive Behavior Disorders through Community Partnership" (David Arnold); (5) "African-American Adolescent Males' Perceptions of Their Community Resources and Constraints" (Michael Cunningham); and (6) "Community-Based Interventions into Street Gang Activity" (Sudhir Venkatesh). (KB)

In 1993 the Committee on Science, Engineering, and Public Policy issued a report titled "Science, Technology, and the Federal Government: National Goals for a New Era" (the Goals report) which proposed a framework for federal policy to support science and technology. This document can be considered a companion volume to the Goals report and aims at reshaping the current Ph.D. experience and improving students' ability to make good career choices. Topics covered include: the changing context of graduate education; employment of graduate scientists and engineers including current employment conditions, employment trends, employer perspectives, and the changing context of employment; the education of graduate scientists and engineers including the master's experience, the doctoral experience, time to degree, mechanisms of assistance, career information and guidance, the graduate education of women and minority-group students, foreign graduate students, and postdoctoral education; and a discussion of major related issues including the right number of science and engineering Ph.D.s, the issue of foreign students, time to employment, and information and analysis needs. Recommendations, statistical figures, and data tables are included. Seven appendices include statistics on graduate education of scientists and engineers and employment trends among scientists and engineers with graduate degrees. Contains 66 references. (JRH)

Health services research is a multidisciplinary field that investigates the structure, processes, and effects of health care services. This report focuses on one part of the field of health services research--its work force and its programs for educating and training that work force. This study undertook the following information collection activities: (1) a survey of directors of health services research training programs in the United States and Canada; (2) creation of a database of health services researchers in the United States; and (3) telephone interviews or panel discussions with key individuals in state governments, managed care organizations, hospital systems, consulting firms, and other nonacademic organizations. One of the first findings was that existing data on the size and characteristics of the health services research work force are fragmentary and incomplete. Recommendations are made to update and extend the database created for this study, to survey those with doctorates in health services, and to investigate the career paths and productivity of those who receive trainee grants or fellowship awards. Findings on work force supply and demand, training programs, and the need for future health services research are also included. Appendices provide additional information on: the new database on the health services research work force, the survey of educational programs, and multistate life table methodology. (Contains 77 references.) (CK)

This report summarizes the activities of two workshops on child care options for low-income families. The workshops focused on factors affecting patterns of child care use among low-income families, child care and children's development, child care and economic self-sufficiency, and the structure and consequences of child care subsidies. It concludes that: (1) low-income families resemble other families in the considerations that guide their child care preferences and choices; (2) there is a relatively low supply of care for infants, school-age, and special needs children; (3) the quality of care available to low-income families is highly uneven; (4) variation in child care quality has discernable and significant effects on children's development; (5) continuity of care is an especially important issue for low-income families; (6) child care subsidies appear to facilitate low-income families' efforts to obtain and maintain paid employment; and (7) federal funding levels that restrict states' capacity to provide subsidies to all qualified families lead to a series of detrimental consequences. A list of workshop participants is included. An appendix contains the workshop agendas. (Contains 33 references.) (MDM)

The largest segment of the American work force consists of high school graduates who have not attended college. New graduates usually start in entry-level positions but soon move into other occupations and other, often larger, organizations. Today's graduates should expect many changes that will affect their ability to succeed in the work force. These include demographic and structural changes, the effects of foreign competition, the requirements of new modes of organization, and the impact of new technologies. Employment opportunities are expected to be found in all kinds of organizations, especially small firms. The worker who will prosper in the future will strive for these core competencies required by employers: command of the English language, reasoning and problem solving abilities, reading, writing, and computation skills, a firm grounding in science and technology, oral communication abilities, positive interpersonal relationships, some understanding of American social and economic structures, and constructive personal work habits and attitudes. Employers, school boards, schools, parents, students, government, and community all share the role of preparing students adequately for work. Their closer cooperation is urged in developing the career guidance, information, and training that prospective workers and their teachers need. (YLB)

This book is addressed to anyone involved with or affected by the Acquired Immune Deficiency Syndrome (AIDS) epidemic, including legislators, researchers, health care personnel, insurance providers, educators, health officials, executives in the pharmaceutical industry, blood bank administrators, and other concerned individuals. The following areas are covered: (1) confronting AIDS: summary and recommendations; (2) understanding of the disease and dimensions of the epidemic; (3) the future course of the epidemic and available national resources; (4) opportunities for altering the course of the epidemic; (5) care of persons infected with human immunodeficiency virus (HIV); (6) future research needs; and (7) international aspect of AIDS and HIV infection. Appendices include information on: (1) clinical manifestations of HIV infection; (2) serologic and virologic testing; (3) risk of HIV transmission from blood transfusion; (4) U.S. public and private sector resources for fighting AIDS; (5) the Centers for Disease Control's (CDC) surveillance definition of AIDS; (6) CDC classification system for HIV infections; (7) Public Health Service plan for prevention and control of AIDS and the AIDS virus; (8) list of background papers; (9) list of presentations at public meetings; (10) acknowledgments; and (11) biographical notes on committee members. A glossary of terms is included. (JD)

The Government-University-Industry Research Roundtable created a working group of government officials, corporate executives, university administrators, and scientists to examine current trends in the university research enterprise, predict the impact of trends on the future of the enterprise, determine the options for the future of the enterprise, and explore national strategies for meeting the challenges of the future. The working group's progress in analyzing the status of scientific and technological research in academic settings and identifying central issues is described. The first section outlines the status, trends, and issues in academic research in science and technology. Identified trends include the following: (1) the environment in which the academic research community must function will increase in complexity; (2) during the next decade, faculty retirements will increase demand for academic research personnel; and (3) sustaining the quality of current research institutions and programs is increasingly expensive. The second part summarizes trends and distributions in national and academic research and development expenditures, total academic expenditures and revenues, academic personnel, higher education enrollments, and science and engineering degrees. A substantial number of illustrative graphs are included. (MSE)