We interviewed 200 Latino parents (50 Mexican couples, 50 Puerto Rican couples) living in the United States to determine needs and supports related to raising a child with a disability and to identify variables related to reported needs and supports. The pattern of needs expressed was similar to that found in previous studies, but the number was substantially higher. More support was reported from family and formal sources than from friends or informal sources. Using repeated measures of analysis of covariance involving six family variables and three child variables, we found that English language proficiency was the only variable to account for significant variance in needs and supports.

Key PointsQuestionWhat is the association between mortality and increasing treatment coverage for eating disorders, taking into account individual-level eating disorder disease dynamics?FindingsIn this decision analytical model study, the estimated lifetime prevalence of eating disorders is high, with nearly 1 in 7 male individuals (14.3%) and 1 in 5 female individuals (19.7%) experiencing an eating disorder by age 40 years. Increasing treatment coverage for all eating disorder cases could avert 70.5 deaths per 100 000 individuals by age 40 years.MeaningThe findings suggest that increasing treatment coverage for eating disorders could substantially reduce the mortality associated with these common psychiatric disorders.

therapeutic needs, (c) identifying the range of services which potentially could help support them and their child, and (d) gaining access to those services. The Individuals with Disabilities Education Act (IDEA) assures that a system exists to help accomplish these tasks. However, it appears that considerable variation exists in the extent to which parents are aware of, use, and are satisfied with services. Many factors likely in-

we examine how 150 Latino mothers ofyoung children with developmental disabilities use narratives to express and create self-understandings ois-a-ois their child. The purpose is twofold: (a) to introduce narrative as a tool that people use to make sense ofdisability, and (bJ to demonstrate how these mothers draw on cultural beliefs and the narrative form to construct meanings ofselfin relationship to disability. An analysis ofspontaneous narratives ofselfand disability reveal that the majority ofmothers portrayed themselves as good mothers in line with larger cultural notions, and viewed their child as bringing about positive transformations in their lives. we end by suggesting ways that narrative analysis could be used in future research andpractice.H aving a child with a disability raises key questions that parents are likely to continue to revisit as their child matures and as the child and family undergo transitions in school and other life experiences. Many of these questions focus on practical concerns: (a) how to teach the child and provide an environment that maximizes his or her development; (b) how to assure that the child receives the services and supports necessary to succeed in Exceptional Children school and life outside of school; (c) how to cope with the various demands and expectations that come with having a child with a disability; and (d) how to understand the cause and characteristics of the child's condition. Other questions, however, reflect deeper concerns with meaning and purpose in life: (a) how can I make sense out of why this happened to my child; (b) what does it mean for me and my life; and (c) what is its meaning in the larger world?

Background Dual HIV and syphilis testing might help to prevent mother-to-child transmission (MTCT) of HIV and syphilis through increased case detection and treatment. We aimed to model and assess the cost-effectiveness of dual testing during antenatal care in four countries with varying HIV and syphilis prevalence. Methods In this modelling study, we developed Markov models of HIV and syphilis in pregnant women to estimate costs and infant health outcomes of maternal testing at the first antenatal care visit with individual HIV and syphilis tests (base case) and at the first antenatal care visit with a dual rapid diagnostic test (scenario one). We additionally evaluated retesting during late antenatal care and at delivery with either individual tests (scenario two) or a dual rapid diagnosis test (scenario three). We modelled four countries: South Africa, Kenya, Colombia, and Ukraine. Strategies with an incremental cost-effectiveness ratio (ICER) less than the country-specific cost-effectiveness threshold