‘The times,are they a‐changing?’ As the world enters a new millennium are we as paediatricians keeping up with the changing needs of children?

This paper describes changes that are occurring in paediatric practice in a variety of settings. The ‘new morbidity’ demands focused training of paediatricians of the twenty‐first century. Areas that include advocacy, public health, adolescence, chronic illness, health promotion, behavioural issues, parenting and family dynamics, social influences, health and social inequalities, managerial decision making and technological advances should be a part of paediatric training. These factors assume different importance in developing nations where priorities may be more focused on public health, nutrition and health promotion. Partnership with others who have children's interests at heart, for example mental health services, public health, social sciences, education and social services is imperative in planning service development informed by good information systems incorporating measures of mortality and morbidity. Copyright © 2000 John Wiley & Sons, Ltd.     

Early Indicators of Male Reproductive Toxicity

Longitudinal data were analyzed for seminal characteristics of rhesus monkeys and beagles. The monkeys were exposed to DBCP; the beagles were exposed to acute or chronic whole body gamma irradiation. The semen was analyzed for volume and sperm concentration. Sperm were measured for percent motility, swimming speed, and head dimensions. Abnormalities of the sperm tail were also noted. All treatments resulted in measurable effects on the semen parameters. Sperm production, as evaluated by seminal sperm concentration or total sperm numbers in the ejaculate, was as informative of testicular toxicity as any other parameter or combination of parameters. A consistent finding was that changes in sperm output occurred concomitantly with changes in sperm motility.     

The Sex Check: The Development of an HIV-Prevention Service to Address the Needs of Latino MSM

The Sex Check is a brief, telephone-delivered, HIV-prevention intervention tailored for individuals who are at high risk of HIV infection or transmission but who are neither reducing their risk on their own nor seeking support for this purpose. Because the intervention is delivered on a one-to-one basis, permits anonymity, is marketed to "men who have sex with men," and is brief, it may be particularly responsive to cultural, structural, and attitudinal barriers to serving Latino MSM. Because many Latino MSM continue to engage in high risk sexual behaviors, developing and testing prevention interventions with this population is a public health priority.     

Foster care drift: a risk-assessment matrix

Category I and II families are qualitatively different from families who can be reunited after a short period of service. This matrix attempts to further our efforts at differential diagnosis and case planning early in service delivery. Parents must not be denied the chance to succeed in reversing problems that put their children at risk. Children must not be made to suffer the effects of foster care drift, however, while their parents continually fail to meet their needs. Front-loading of services and early determination of the parents' willingness and/or ability to change protect children's right to a permanent and stable home.     

The emerging self in conceptualizing and treating mental illness

1. The course of severe mental illnesses is more heterogeneous than previously thought and is influenced by many complex, interacting factors. 2. The experience of self and capacity to cope of people with mental illnesses contribute to the recovery process. 3. Changes in traditional treatment models and a focus on broader societal interventions are needed to facilitate recovery. 4. Psychiatric nurses play an important role in these new developments as evident, for example, in the 3R Program (relapse, recovery, and rehabilitation).