Disability profile and health care costs of Medicare beneficiaries under age sixty-five.

Medicare has more than five million beneficiaries with disabilities who are under age sixty-five, and enrollment is rising rapidly. This paper presents a profile of nonelderly beneficiaries in fee-for-service Medicare by major disability category, excluding those with end-stage renal disease. The profile is based on Medicare Current Beneficiary Survey (MCBS) Cost and Use data for 1994-1996. We estimate Medicare costs by service type and health care costs by payer type, and we discuss implications for Medicare reform and related federal disability policy issues.

An architect's perspective on contemporary academic library design.

The making of space and place (architecture) requires cultural and financial consent as to societal value. Standards and values about the academic library of the immediate future are not always shared by librarians and architects; however, architects and librarians do possess several shared perceptions. Among these shared perceptions are that print collections will remain a primary function of libraries for the foreseeable future, flexibility in shelving arrangements are essential, adjacencies must be fluid, floor-to-floor heights should be generous, compact shelving has become commonplace, print and electronic media must coexist, and technology has not reduced library space requirements. Experience reinforces the continuing and increasing significance of the library on college and university campuses.

On the design of the Health Sciences Library/Information Services building at the University of Maryland at Baltimore.

The architect provides his perspective on issues in designing a new library building, including: civic and urbanistic purposes of the building; the process of analysis and synthesis; and the place and meaning of 'library' today. Special attention is given to adjacencies, reader services, space devoted to the study of change, administration, and presentation and itinerary. A verbal floor-by-floor tour of the building is provided.

Cross-cultural family medicine residency training.

Over the past four years the University of California, San Diego (UCSD), Family Medicine Residency Program has developed a cross-cultural training program. The goal of the program is to prepare residents to function as effective health care providers in medically underserved areas with ethnically diverse patient populations. The required training activities include (1) a Spanish language course, (2) a clinical rotation in a community health clinic serving a Hispanic, medically underserved population, (3) a preceptorship in home-based health education and counseling for Spanish-speaking families, and (4) a set of cross-cultural sensitivity training activities that are part of the Residency Behavioral Science Program. The UCSD Cross-Cultural Family Medicine Training Program is described here as a prototype for consideration by other family medicine residency programs.