Discrimination based on group characteristics other than mental illness does not diminish the impact of stigma associated with mental illness. Antistigma programs need to target not only discrimination related to mental illness but also that associated with other group characteristics, such as race, gender, sexual orientation, and physical disability.

The development of polio vaccines 50 yr ago essentially halted childhood polio epidemics in the industrialized world. During the past quarter century, a constellation of delayed neuromuscular symptoms, called postpolio syndrome, became recognized among the aging polio survivors. The prevalence of postpolio syndrome in the U.S. population is estimated to be in the hundreds of thousands. The most common symptoms are fatigue, pain, and new onset weakness thought to be related to delayed deterioration of motor neuron function. When a patient with postpolio syndrome presents for surgery, special precautions are warranted, because these patients may have respiratory impairment, sleep apnea, swallowing difficulties, and cold intolerance. This article first reviews clinical features and some pathoetiologic theories of postpolio syndrome and then focuses on anesthetic considerations including the use of common anesthetics, neuromuscular blockade, regional anesthesia, and general anesthetic management strategies.

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The authors summarize the health care problems facing rural and frontier America by addressing five key issues within the framework of health care for the whole person: how to (a) provide health care access, (b) ensure health care quality, (c) provide a range of health care or meet the scope of practice demands, (d) address regional, rural-specific characteristics that may exist, and (e) address health professionals' quality of life. When working in rural and frontier areas it is crucial for providers to collaborate across all types of health care to provide better care and better utilize a region's tautly stretched resources. Rural health care resources are provided. The authors attempt to demonstrate characteristics of rural culture and rural and frontier populations' health care disparities, highlighting the need for collaborative care.

We found IN fentanyl, which can be administered in a variety of care settings, to be a minimally invasive means of palliating distress in dying newborns and infants. No adverse events related to its use were noted.