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A study of 78 parents of Down's syndrome children shows that, while most were in favour of abortion for a handicapped fetus, they were divided equally on whether euthanasia (no distinction made between active and passive euthanasia) was an acceptable practice. Only a third considered an average Down's syndrome child could be a suitable candidate for euthanasia. While parents argued that the degree of handicap of the child was the crucial factor in making this decision, in fact the social class of the parents themselves was the only variable which was statistically significantly related to their opinions. Differences arose from the parents' lack of agreement on what constituted a sufficiently severe handicap. [ABSTRACT FROM PUBLISHER]

A study of two cohorts of Down's syndrome children living at home in South Wales and born in 1964-66 and 1973-75 respectively shows that there are significant differences in the characteristics of their families. Parents of those born in the seventies were younger at the birth and of higher social class than parents with children born in the sixties. In the seventies the Down's syndrome child was more likely to be the couple's first child. Most changes result from the introduction of the amniocentesis test which is offered to older pregnant women. It is suggested that the social class differences are likely to be explained by changes in fertility in the various social classes. [ABSTRACT FROM PUBLISHER]

Objectives: To assess the evaluative research literature on the costs, quality and effectiveness of different locations of care for older patients., Methods: A systematic review of evaluative research from 1988 using CRD4 guidelines. Twenty-five databases were searched, using processes developed specially for this review. Library OPACS, the Internet and research registers were also searched for relevant material. The final stage of the review was confined to randomised and pseudorandomised trials. Studies were selected for review by pairs of researchers working independently who then met to reach a decision. Analysis was predominantly descriptive; simple pooled odds ratios were used to explore some outcomes., Results: Eighty-four papers from 45 trials were included. Firm conclusions were difficult to draw, except in relation to some outcomes for stroke units, early discharge schemes and geriatric assessment units. Few trials in this area have adequately addressed issues of patients' quality of life and costs to health services, social care providers, patients and their families., Conclusions: Despite considerable recent development of different forms of care for older patients, evidence about effectiveness and costs is weak. However, evidence is also weak for longer-standing care models. A substantial service evaluation agenda emerges from this review. This study also raises questions about the usefulness of systematic review techniques in the area of service delivery and organisation.