Cost containment trends are leading to major cutbacks and downsizing in health care facilities nationwide. Under these circumstances, it is particularly encouraging that the Institution (Montefiore Medical Center of the Albert Einstein College of Medicine) has seen fit to expand (with additional space and hospital paid personnel) the Sickle Cell Clinical Facilities developed by this Core in the previous period. This is a testament that the investigators have accomplished prudent but innovate quality care for the patients, and in a manner that has satisfied Hospital Administrators as being fiscally responsible and beneficial for the mission of this non-profit but financially solvent private Hospital. The investigators also feel that the investigators have accomplished what funded clinical activities should be: a pilot effort that needs to become self supportive through its own success. In this proposal the expansion of the Day Hospital to two daily cycles instead of the original one, the increase of personnel supplied by the hospital as well as the new physical facility will allow the proposed Clinical core to move to another level of activity. This Core is now in a position to provide better patient support to the research efforts of several of the Projects proposed in this application. The investigators also intend to extend the principles and practices of the Center to other sections of the Hospital and health care new that Montefiore has created in the Bronx and lower Westchester County. The investigators intend to improve the data management to facilitate clinical research. Finally, the investigators are now in a position of sharing the success with other Institutions (including other Centers) in this country and abroad. The investigators have already hosted health workers from the Boston and Philadelphia Comprehensive Sickle Cell Centers. The investigators expect that the next cycle will be a banner five years for the activities of the clinical core.
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