National Disability Institute

The objective of this work was to present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation after stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). Retrospective cohort study of Medicare beneficiaries with any of the 3 conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012, and November 15, 2013. In the final sample (stroke, n = 71 769; TBI, n = 7109; SCI, n = 659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI); 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke; 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. Broad health care policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions.

Spurred by development in computer science and network technology, the use of the Internet has been expanding exponentially. It is now extensively used as a connectivity and reference tool for numerous commercial, personal, and educational purposes. In education, the Internet opens a variety of new avenues and methodologies for enhancing the experience of learning as well as expanding educational opportunities for a larger pool of students. Specifically, distance education and non-traditional classrooms have the capability to reach more students using specialized instruction and self-paced learning. In the area of distance education, many Web-based real time experimentation systems have been reported in the literature (Ando, Graziani, & Pitrone, 2003; Daponte, Grimaldi, & Marinov, 2002; Ko, Chen, Chen et al., 2000; Ko et al., 2001; Kumar, Sridharan, & Srinivasan, 2002; Yeung & Huang, 2003). These Internet-based remote laboratories allow users or students to carry out physical experimental work at their own pace anytime anywhere. They generally require very little physical space and minimal manpower to maintain, and are ideal for the sharing of expensive equipment. However, all these experimental systems can only provide 2D operation panels. Due to this limitation, the actual shapes of 3D instruments and equipment, some of which may have controls or display components on different sides, may not be possible to be reflected on the remote user’s client display window.

In 1992, New York State Department of Health regulations provided for fully legal syringe exchange programmes in the state. The policies and procedures mandated that: 'Each program must seek to recruit for inclusion on its advisory board program participants Programs are also urged to establish other advisory bodies, such as Users' Advisory Boards made up of program participants, to provide input and guidance on program policies and operations.' The inclusion of drug users as official advisors to the legal programmes was seen as a method for incorporating the views of the consumers of the service in operational decisions. The 1992 regulations implied a new public image for users of illicit psychoactive drugs: active drug users were seen to be capable not only of self-protective actions (such as avoiding HIV infection), but alsoof serving as competent collaborators in programmes to preserve the public health. This development has important implications with regard to the evolution of official drug policy, since it will be difficult in future to treat IDUs simply as the passive objects of state intervention. Whether as individuals or representatives of a wider population of illicit drug users, they have acquired a legitimacy and sense of personal worth which would have been unthinkable in previous periods.

The Rehabilitation Institute of Chicago (345 E Superior, Chicago, IL 60611). The National Institute on Disability and Rehabilitation Research: Grant H133B30024.

We describe the partial loss of heterozygosity (LOH) at chromosome 11p loci in normal tissues (normal kidney and/or blood) from four of 67 Wilms' tumour patients. Autologous tumour DNA showed complete loss of the same, maternally derived, alleles. These observations indicate that the normal tissues were mosaic for cells heterozygous and homozygous for 11p markers and that tumours subsequently developed from the homozygous cells that had undergone an 11p somatic recombination event. We suggest that LOH for 11p alleles is compatible with normal growth and differentiation and is significant pathologically only when accompanied by other genetic alterations.

To address a serious manpower shortage in rehabilitation research, the National Institute on Disability and Rehabilitation Research in 1986 created the Rehabilitation Research Career Award. This award is intended to support individuals with advanced clinical training for research careers in fields related to rehabilitation, including arthritis. The paper describes the 7 ingredients considered necessary for a qualified research training program in rehabilitation.