Overspending for 'overbedding'? The Administration cracks the whip.


HMO growth: incentive plan shows signs of success.


Kaiser marks $300 million for HMOs.

Kaiser marks $300 million for HMOs.


Pull leash on costs.

Pull leash on costs.


Health plan would pay the non-user.

Health plan would pay the non-user.


Renovated x-ray equipment: hospital money saver.


Humanizing the intensive care unit for children.


Medline's consignment inventory service praised by clients.


Purchasing the right quality is value buying.


CS supervisors frown on disposable re-use.


HEW seeks to revamp utilization review plan.


Budgeting and the purchasing process.

Budgeting and the purchasing process.


Storerooms: new cost-savings frontier?

Storerooms: new cost-savings frontier?


Drawing the line on reconditioned equipment.


Computerized purchasing key to cost containment plan.


Used lab equipment not attractive to hospitals.


Fee-for-service private practice medicine: the end is in sight.


Salaried doctors.

Salaried doctors.


Microprocessor hoards energy by holding mechanical units to rigid schedule.


Reducing excess capacity: closing down or converting hospital facilities may be easier said than done.


New computer at U. of Iowa Medical Center controls clinical lab record-keeping costs.


Massive support for medical research.

Massive support for medical research.


Future of nursing in Alberta.

Future of nursing in Alberta.


Perceived clinical significance of consultant pharmacist recommendations in the skilled nursing facility. In an attempt to determine if pharmacists could make significant contributions to SNF patient care in the area of disease management, the drug therapy of the residents of two SNFs was reviewed once monthly for six months by two clinical pharmacist consultants. Pharmacist-identified problems and recommendations were communicated in writing to the medical staff by means of a communication form attached to the patient's chart. Nearly 72 percent of the recommendations made were accepted by the SNF physicians. Descriptions of the cases and corresponding recommendations were distributed to review-panel physicians. These physicians were asked to agree or disagree with the pharmacists' suggestions, and to rate the clinical significance of each recommendation using a modified Likert scale. The clinical pharmacist-consultants were perceived to have had a significant input into disease management in SNF patients.


Health services in Alberta: three into one = District 93.


Health services in Alberta: cancer services take a major step.


Geriatrics--gerontology: a challenge and opportunity for pharmacy.


Pharmacy inservice to OR/RR nursing staff.


Rebuilding Edmonton's health sciences centre.


Content and method in a thanatology training program for paraprofessionals. A training program of paraprofessionals was developed in a university teaching hospital. Trainees were exposed to seminars and a supervised practicum. The objectives of the experience included sensitization of persons in the natural helping network to (a) psychosocial needs of seriously ill persons and their families, (b) experience and comfort in interaction with such persons; (c) the structure of the health care delivery system, and (d) the usefulness of peer support groups.


Health services in Alberta: health districts provide unlimited potential.


NAEHMO survey of health care coverage and industry involvement in cost containment.


Health services in Alberta: unique approach to forensic services.


C.H.A. brief to Hall review.

C.H.A. brief to Hall review.


Cardiac rehabilitation--a team effort.

Cardiac rehabilitation--a team effort.


General Dynamics fitness program sparks employee enthusiasm.


Training program focuses on developing managers' skills. The movement toward skill development and behavior modification in the training and staff development field is just beginning to affe(t management training in hospitals. The training model described in this article is adaptable to a variety of tasks involving the management of people.


Company encourages good health with 'well pay,' positive environment.


Health awareness seminar sparks ongoing company program.


What is a fitness program worth?

What is a fitness program worth?


Code of ethics could unify personnel administrators. A variety of factors, such as federal protective labor legislation and unionism, have pushed personnel administration into the forefront of hospital management. The added responsibility brought on by these factors and the growing number of people entering the field have created a burgeoning profession that will require guidance with regard to ethical principles of practice. The following article presents one example of a code of ethics for hospital personnel administrators.


1199s scholarship program.

1199s scholarship program.


A mother and her child: grievance wins leave so 1199er can be at ailing son's bedside.


Brooklyn Jewish: how the fight for a community's health was won.


New York 1199ers tell Mayor Koch: hands off voluntary hospitals.


Power for RNs through 1199.

Power for RNs through 1199.


Advanced cardiac life support: a recertification program for health professionals.


Georgetown University Hospital goes 1199E.


The development of an emergency medical service in New York City.


Managing for motivation in EMS.

Managing for motivation in EMS.


Hospital election win caps 12-year campaign.


New Hampshire RNs go 1199.

New Hampshire RNs go 1199.


Medical malpractice insurance premiums.

Medical malpractice insurance premiums.


States should shun rate controls and concentrate on citizens' health needs.


A method for clinical categorization of emergency facilities.


Health Planning Act: a new testing ground for state vs. federal control.


Health aides' consortium helps governors shape strategy.


Cecil Andrus leads protests of states to P.L. 93-641.


Rubel bows out with strong resolve on planning need.


Bob Appel's story of AMI: birth of an industry.


High court ruling: weapon against conspiracy.


The PRRB: concept passes first tests.

The PRRB: concept passes first tests.


News media regulations.

News media regulations.


Three investor-owned hospitals treat over 150 persons hurt in ammonia disaster at Houston.


Reimbursement decisions facing next Congress.


Settlement or strike?

Settlement or strike?


Nine ways to encourage gifts through recognition. A strong case statement provides a solid foundation to build an appeal, notes the author. He prepared a list of nine ways to encourage increased giving. Be bold about asking for a gift, he warns. Initiative must be grabbed to get donors upgraded.


Regulations force hospitals to re-think mission. Hospital philanthropy is feeling a surge of pressure from government in regulating its costs. Alternative solutions have been proposed, but this author thinks a greater attention to the true purpose of hospitals will be their only relief from future government intervention.


Does the nonprofit form fit the hospital industry? Nonprofit hospitals currently enjoy favored legal status. In this Article, Professor Clark critically examines the basis for such preferential treatment. He begins by identifying endemic problems in the health care industry and then explores the relationship between nonprofit hospitals and these problems. He finds that the evidence does not persuasively establish that nonprofit hospitals serve as fiduciaries rather than exploiters, and that nonprofits engage in much involuntary cross-subsidization of medical services. He concludes that the legal favoritism for the nonprofit form is based not on sound reasoning and hard data but on intuition. Professor Clari proposes that the legal rules affecting nonprofit hospitals reflect this reality by treating both nonprofits and for-profits neutrally, by controlling cross-subsidization, and by strengthening consumers' information about and control over health care decisionmaking.


"... But my patient is dying".

"... But my patient is dying".


Reflections on whole-body transplants.

Reflections on whole-body transplants.


For most doctors practicing under National Health Insurance in Canada, the pros outweigh the cons.


Component approach to energy budgets.

Component approach to energy budgets.


Congress told to lift restrictions on foreign-trained doctors.


Justice Department gives planning program partial OK on antitrust.


Affirmative action: take aim at discrimination.


Coping with the nursing shortage.

Coping with the nursing shortage.


Developing valid employee appraisal systems.


The hospital auxiliary's role in the organization.


Cutting hospital losses.

Cutting hospital losses.


Task forces: reap big rewards at small costs.


Uncovering organizational problems through employee surveys.


What motivates employees?

What motivates employees?


How "good employee relations" can prevent and win labor disputes.


A plan for integrating the new employee.


A continuing education program that insures quality care.


The power of supervision.

The power of supervision.


Rights, wrongs and risks of patients' charter campaign.


Learning to take it easy.

Learning to take it easy. Stress can be deadly and more and more people are seeking outside help in dealing with it. Leicestershire AHA is taking positive steps; Vivienne Evans, senior health education officer, describes a scheme to teach people who feel under threat from stress to relax.


Pharmacy: a unique opportunity to participate in education. Health education and health maintenance are part of the traditional role of the pharmacist, particularly for those engaged in general practice (retail) pharmacy, writes J. W. Barnett, APhO Hereford and Worcester AHA, in the last of our series. Pharmaceutical officers have many opportunities to exercise this professional role themselves either by direct contact with the public, or indirectly by helping and advising others. Although this generally involves educating the public on medicines, wider issues are also involved -- for example, fluoridation and the risk of poisoning from household chemicals.


Cottage hospitals: Cranleigh's loyal army keeps its history alive. It never called itself a cottage hospital, but it started the cottage hospital movement which gave Britain a network of small hospitals unique in the world. Nick Davidson visits Cranleigh Village Hospital for the first article in a series on the small hospitals now once more in favour, as the reaction sets in against the cult of bigness.


Hospital catering: more plates for more patients. Hospitals which increase in size in terms of buildings and beds present problems to catering staff especially when the buildings are a mixture of old and new. Existing facilities are seldom adequate to cope with extended distances between wards or throughput of meals for an increasing number of patients. The Royal Sussex County Hospital at Brighton has solved most of its problems with the opening of a new catering complex described here by John Neale, district catering manager.


Hospitals: problems of creating a sense of security. Next week British and American experts will meet in a hospital security management seminar to be held at Charing Cross Hospital, London, under the auspices of the International Association for Hospital Security. In this article, Charles Morris, district security officer, Central Derbyshire Health District, looks at hospital security in the context of the British NHS and its current financial problems.


District profile: the shoe fits at Northampton. An old county town that has retained its individuality through all the changes of the last three centuries, and is expanding vigorously to meet the challenge of the next--that is Northampton. The health services of the district reflect the town, and draw strength, as they always have done, from close links with the community they serve.


Mental health: shaping new models in the European workshop.


Health services: shadows in the valleys.


Cottage hospitals: singing the praises of an unsung gem of the NHS. You are not a mere case, or number, or symptom at Lynton Cottage Hospital in Devon. You are, in the words of Pauline Garnham, its matron, a "whole person'. Nick Davidson drove down the village high street with Mrs. Garnham. It was, he writes, like a royal procession. A wave here, a nod there: no chance of being inconspicuous in a world whose smallness is its endearing, not to say enduring, beauty.


Monitoring: making use of the tools which are available. "Count what is countable, measure what is measurable and what is not measurable, make measurable'. Dr Brian Moores of the University of Manchester Institute of Science and Technology endorses Galileo's words but would add that having counted and measured, we could make much more use of the techniques developed.


Joint care: a creative use of resources. The National Development Team for the Mentally Handicapped argues that social work in hospitals for the mentally handicapped needs to adopt "a more dynamic approach' to the problems of families of the mentally handicapped. By way of agreement, John Tebbet offers an account of how a social work team based in a health setting has tried to create new low cost community resources.


The hard sell for savings. Interview by Sally Burningham. The NHS might seem to present an opportunity to purchase, store and distribute on a national basis but it is, in reality, a series of largely autonomous local services. According to Graham Hart, DHSS controller of supply, in most parts of the country supplies are held in 'a variety of small, local stores unsuited to their purpose'.


Reaction and repercussion: the period of consultation on the proposals to restructure and reorganise the NHS has now drawn to a close.


Pharmacy: eight signposts to follow after Noel Hall milestone. If existing health districts were to become DHAs many would not be viable units of organisation for pharmaceutical services. John Barnett, David Carrington and Keith Munns, chairman, vice-chairman and secretary respectively of the Association of Area Pharmaceutical Officers, report on a survey of the association's membership which provided evidence for an eight-point plan for pharmacy.


Care for the elderly: a different dimension. The geriatric day hospital has established a place in the services for the elderly. That place is examined in detail in a new book 'Progress in Geriatric Day Care', by J. C. Brocklehurst and J. S. Tucker (King's Fund, pounds 7.00). Here Professor Brocklehurst, who holds the chair of geriatric medicine at the University of Manchester, outlines some of the book's findings. The illustrations are of the day hospital attached to the Department of Geriatric Medicine, St Thomas's Hospital, London.


Problems in purchasing IV solutions.

Problems in purchasing IV solutions.


Get rid of de facto prime vendors.

Get rid of de facto prime vendors.


The human side of materials management.

The human side of materials management.


Mary Ingmire at Silver Cross says: "They just say 'Thank you' all the time".


Bridging the information gap.

Bridging the information gap.


The importance of journal publications in information transfer for the health sciences.


Danbury Hospital Health Sciences Library in Connecticut.


When patients become patrons...patient education in the public library.


Explaining reference literature and search processes.


Tinley Park Mental Health Center Library ... in Illinois.


Hospital library cooperation in Kentucky, Ohio & Michigan.


On the road to effective hospital library committees. Part 1.


Augustana Hospital Library in Chicago...immediate response and service for all.


St. Vincent Hospital Library in Indianapolis.


Hospital library staffing patterns: a survey.


St. Joseph Hospital Library in Chicago.

St. Joseph Hospital Library in Chicago.


Saint John Hospital's Medical Library in Detroit.


Touro Informary Libraries in New Orleans.


How to succeed in librarianship by really trying!


St. Thomas Hospital Library in Nashville.


The librarian as facilitator of patient education.


Copyright and the librarian.

Copyright and the librarian.


John A. Taft, Jr., Administrator, Delnor Hospital, St. Charles, Illinois.


Reactions to hospital library money survey.


The Ottawa General Hospital (fifty beds) and George C. Andrews, Administrator.


Policies for the hospital library.

Policies for the hospital library.


What's a librarian doing in a hospital?

What's a librarian doing in a hospital?


One librarian for six hospitals.

One librarian for six hospitals.


Developing a health science information network in rural eastern Kentucky.


How to find a librarian.

How to find a librarian.


Visit to Jewish General Hospital, Montreal, Quebec.


Hospital administrators should hire librarians!


The hospital administrator and fund raising.


Fireplace in the hospital library.

Fireplace in the hospital library.


A "communication consortium".

A "communication consortium".


Dr. Angel Leano Hospital Library, Guadalajara, Mexico.


Implementing S.D.I. in the hospital library.


Book-look: pointers on new books.

Book-look: pointers on new books.


National Library of Medicine; extramural programs.


$50,000 grant for the Central DuPage Hospital library.


Hospital library standards for 1980 and beyond: professional library services.


Librarians who work in two or more hospitals.


A quartet of attitudes on interviewing and being interviewed.


Protecting the immunosuppressed.

Protecting the immunosuppressed.


Routine urine cultures needed?

Routine urine cultures needed?


Committee records not admission of negligence.


What should be the regional role?

What should be the regional role?


The district and unit functions.

The district and unit functions.


Air flow patterns in the operating theatre.


The viability of the new authorities in estate management.


Health buildings--fire precautions.

Health buildings--fire precautions.


The Home Office approach to hospitals and the Fire Precautions Act 1971.


Aerial heat loss survey of hospitals.

Aerial heat loss survey of hospitals.


The working of a common services agency and, in particular, a building division.


Accountability.

Accountability.


Management--what's it all about?

Management--what's it all about?


Medicine and machines.

Medicine and machines.


The efficient utilisation of steam.

The efficient utilisation of steam.


Records' confidentiality at risk without new legislation.


Report of CHAC convention: CHAC tackles thorny issues of pastoral care and continuing sponsorship.


St. Joseph's Hospital, Lancaster, PA. Pioneer in lay ministry faces special challenge.


St. Elizabeth Medical Center, Covington, KY. Self-contained medical village emphasizes planned growth, convenience.


An interview with Sr. Joanne Upjohn, CSC, Chairman, CHA Board of Trustees.


Pastoral care: recognizing life as multidimensional. Human life is multidimensional; physical illness touches both the physical and spiritual dimensions. Total health is possible only when the body and spirit are integrated into one reality. The pastoral care department's goal is to integrate scientific growth and spiritual values--for patients and staff alike--to ensure the spiritual dimension of healing.


Children's health care needs lack broad-based constituency. With no consensus for action on children's behalf, the hard-won gains of the 1960s will diminish. Governmental expenditures for child health needs have steadily decreased in the face of a worsening economy. Consensus is critical to reverse this trend.


Disaccredited hospital's services claimed substandard.


Stewardship in the 1980s: call to justice, prophetic care.


Setting up a marketing department: why? How? Marketing is assuming a new and more critical importance in the health care field as institutions struggle with rising costs and increased consumer demand. Techniques once considered manipulative and unethical in the not-for-profit sector, however, can be successfully and honestly implemented.


Traveling service agency promotes health maintenance. Persons need help in setting goals to achieve well-being. A traveling health service agency offers lectures and films on nutrition, podiatry, circulation, and coping with loneliness.


Mercury poisoning.

Mercury poisoning.


Permanent catatonia ascribed to suspected subdural hematoma.


GAO report determines lack of "federal focal point"--hinders low-level nuclear waste disposal policy development.


AHR comment period ends: congressional analysis begins.


Action alert: hospitals should act now to preserve right to appeal the malpractice issue.


Court rules that physicians may strike without advance notice.


Administration proposes program to limit support for hospital construction in overbedded areas.


U.S. Regulatory Council's hospital project progresses--outcome uncertain.


Keep an eye on OR staff costs.

Keep an eye on OR staff costs.


OCR's move into health access arena evidenced in new general hospital civil rights survey.


Tune-in to prime time health care.

Tune-in to prime time health care.


Burn unit concerns sparked by Chapais.

Burn unit concerns sparked by Chapais.


Cell separator battles infection.

Cell separator battles infection.


Professionals debate mandatory measures.


Health education is no place to cut back.


There are pluses for horizontal plan.

There are pluses for horizontal plan.


Hospital topical law: damages for breach of a contract.


Centre reorganizes to meet 1980s.

Centre reorganizes to meet 1980s.


Birthing room feels "homey".

Birthing room feels "homey".


Councils need clout--how much is enough?


Planning a hospital-based patient education system.


New centre blends security, treatment.

New centre blends security, treatment.


Attributes of hospital suppliers that influence hospital buyers.


Job tension among unit managers.

Job tension among unit managers.


Labour arbitration: back-pay is a ticklish issue.


Results of a survey: clinical dietetic staffing practices in 138 short-term acute care hospitals.


Infection control in the laundry.

Infection control in the laundry.


A safe psychiatric unit.

A safe psychiatric unit.


The cost containment-quality of care issue.


Consultant's corner: questions to ask a prospective construction manager.


Material management Q's & A's: service component.


Pharmacy news and views--professional burnout.


Financially healthy management of health: INA's health care management business.


Educate linen execs for health and finance.


Tri-level planning proves best.

Tri-level planning proves best.


WP--it's more than a typewriter.

WP--it's more than a typewriter.


Women have made it--more to follow.

Women have made it--more to follow.


Calgary parents have high hopes for diet.


Be prepared for future strikes.

Be prepared for future strikes.


The legal aspects of health records.

The legal aspects of health records.


Day care--treatment pattern of the future.


Inequality defeats health care goals.

Inequality defeats health care goals.


Day hospitals--health and home linked.

Day hospitals--health and home linked.


Maternity leave: a shelter or sword?

Maternity leave: a shelter or sword?


Easing the trauma of hospitalization.

Easing the trauma of hospitalization.


Flow charts help uncomplicate change.

Flow charts help uncomplicate change.


Getting, and keeping your nurses.

Getting, and keeping your nurses.


Participative method of cost containment.


Make plans based on strategy.

Make plans based on strategy.


AIA awards: an excellent prognosis.

AIA awards: an excellent prognosis.


Do we have the will and the way?

Do we have the will and the way?


Malpractice revisited: still coping with the crisis.


Malpractice revisited--Physician-owned companies: the road to recovery.


Risk management: preventive medicine for hospitals.


Health manpower indicators.

Health manpower indicators.


Health manpower utilization in the 1980s.


Employment, hours, and earnings in the health care sector.


Selected national economic indicators.

Selected national economic indicators.


Selected community hospital statistics from the National Hospital Panel Survey.


Medical care prices.

Medical care prices.


The value of values.

The value of values.


Sensitivity and awareness are keys to good management.


Consider the human factor.

Consider the human factor.


What to do when the union beckons.

What to do when the union beckons.


Competition among hospitals.

Competition among hospitals.


Peer evaluation.

Peer evaluation.


What executive managers should know about the grievance procedure.


New frontiers: nontraditional approaches to education.


Legal and regulatory issues in hospice care. The philosophy of hospice care is to improve the quality of the patient's life by alleviating pain; controlling symptoms; and caring for the emotional, physical, and social needs of the dying patient. This concept presents new medicolegal problems with regard to regulation and reimbursement.


Does a patient have a right of access to his hospital medical records?


OTA studies estimates of physician supply in 1990.


A simple work measurement system that can aid in effective production planning. With the advent of increased controls in the hospital field has come the mandate for more efficient use of available resources. Production planning is the mechanism by which these efficiencies can be gained. Ongoing measurement of various work components must be conducted and retrospectively compared to make meaningful use of production planning techniques. The pharmacy department at Brokaw Hospital, which utilizes a unit dose drug distribution system combined with intravenous admixture and monitoring services, has developed an internal measurement system based on key variable weighted units of service. Each component is assigned a value depending on time needed (in minutes) for completion. The units are tabulated daily, with the monthly sum being divided by departmental manhours to yield a monthly productivity ratio. This ratio is used as an aid in making decisions related to work assignments and staff scheduling. Compared against the productivity ratio of a benchmark month of known departmental efficiency (derived by measuring all activities for the month divided by man-hours consumed), projections can be made for future manpower requirements.


Analysis of dispensing activities before and after decentralization of pharmaceutical services. Changes in drug handling activities, revenue, and telephone communications were documented during a conversion from a centralized unit dose system to decentralized pharmacists and unit dose services in a 310-bed university teaching hospital. All decentralized services were mobile; no physical satellites were utilized. Computer programs were used to collect and analyze drug handling and revenue data during a prestudy control period and three equal-length study periods after decentralization of pharmaceutical services for five patient care areas of the hospital. All telephone calls to the central pharmacy were recorded and classified by type during 21 days of the prestudy period and were compared with 21 days of the second postimplementation period. The mean number of doses handled decreased for all patient care areas. After decentralization the number of telephone calls to the central pharmacy requesting clinical drug information, as well as distributive information, decreased sharply. Moving the pharmacist to the patient care unit decreased the time that pharmacists spent handling drugs and improved communication with the medical and nursing staffs.


Association for the Care in Hospitals: statements of policy for the care of children and families in health care settings.


Psychoesthetic environmental design for pediatric care facilities. Since the emotional reactions of children have a direct effect on their health exclusive of their disease, health care facilities are obligated to serve the psychological and emotional needs of pediatric patients as well as their physiologic needs. Following guidelines of certain environmental and psychological studies, intelligent and creative decoration can be executed by use of elemental design principles to achieve the atmosphere in a facility capable of satisfying the demands of the patient, the family, and the working personnel.


When nurses compete with parents.

When nurses compete with parents. Subtle competition flourishes between parents and nurses in neonatal intensive care settings. Because the parents have so little opportunity to contribute to the care of their infants, and because they come to the experience with a broad range of emotional preparation, they often feel displaced by the competent and occassionally overprotective staff nurses. The nurses may not recognize the subtle forms of competition but they do cope with outcomes: hostile or uncooperative parents. This article describes competitive situations, discusses the impact upon the family, and recommends alternatives to competitive nursing care.


Contemporary perceptions of unionization in the medical profession: a study of attitudes of unionized and non-union physicians. This study investigated current perceptions of a sample of unionized and non-unionized physicians toward the concept of collective bargaining. Specific areas for study were the issues that have motivated and might motivate physicians to unionize, as well as the individuals or institutions physicians perceive as the opponent in collective bargaining. The analysis showed that economic considerations and the imposition of external controls on the practice of medicine dominate the physicians' perceptions. Government and health insurance companies are perceived as the primary adversaries. Perceptual differences between unionized and non-unionized physicians were shown to be small.


Promoting appropriate therapy in a long-term care facility.


Pharmaceutical services in skilled nursing facilities.


Pharmacist's involvement in the long-term care facility.


A look at chapter 10 of the Life Safety Code and anticipated 1976 edition changes.


The volunteer member: report on the 1975 VSC survey.


The 'new look' for health centers.

The 'new look' for health centers.


The rhythm of reality.

The rhythm of reality.


Three views: patient assessment: its use in long term care facilities.


A challenge: activities projects.

A challenge: activities projects.


Landmark?: United States Supreme Court recognized the issue of the constitutional rights of civilly committed mental patients.


A look at twelve efficient and effective nursing homes.


The AHCA member: final report on the 1975 survey.


Will shortages of raw materials and rising prices hurt our chances for better health care?


New life for the elderly: liberation from 'agism'.


Sources of capital financing for long term care facilities.


The use of patient assessment forms.

The use of patient assessment forms.


Representing health facilities: the challenge of association management.


Peer review: the aims and guidelines of a program to improve quality of care.


Some solutions for in-service training in skilled nursing facilities.


The comparative health data program.

The comparative health data program.


The psychiatric-geriatric patient.

The psychiatric-geriatric patient.


The bowling tournament.

The bowling tournament.


The resident council: a survey.

The resident council: a survey.


Prescribe art therapy for "back wards" too.


The other side of art therapy.

The other side of art therapy.


Dance therapy in the psychiatric hospital.


Psychodramatic treatment for psychiatric patients.


The creative arts therapies: an overview.


Some advantages of art therapy in the treatment of the schizophrenic patient.


OSHA's enforcement policy.

OSHA's enforcement policy.


EDP contingency planning: how to survive a disaster.


Setting up a company productivity program.


Hospice care: its implications and influence on current health care concepts.


Bureaucrats, legislators, and the decline of the state mental hospital.


Self-concept among institutionalized and non-institutionalized elderly.


The male-female management team: a dance of death?


FDA's new vending code: a review.

FDA's new vending code: a review. The concept of developing and promoting the nationwide adoption of uniform sanitation regulations for food and beverage vending was agreed upon by the U.S. Public Health Service and industry leaders more than 20 years ago. Two revisions of the original Vending Code which was published in 1957 have kept pace with industry changes, the most recent now available in booklet form. Trends in food and beverage vending prompted code revisions resulting in the 1978 Vending Code which has major changes and effects on existing state and local regulations.


What is hospital cost-cutting doing to doctors?


Why you can't rely on a hospital consent form.


The HMO flop that gave fee-for-service a black eye.


Payment by diagnosis: what does it mean for you?


Can you sue your insurer's lawyer for settling a claim?


Computed radiography.

Computed radiography.


National Library of Medicine uses high-density mobile stacks.


Medical group managers: beware of the wage-hours laws. Are the policies and practices of your group in accordance with the amended Fair Labor Standards Act of 1938?


The harvesting of an MRA.

The harvesting of an MRA.


On-line medical record abstracting.

On-line medical record abstracting.


A new approach to psychiatric progress notes: musical score model.


When is a group a group? The case of university medical practice plans. A discussion of the background information on university practice plans and a number of the major issues that occupy the energies of the practice plan administrator.


Interaction analysis: an application for medical record administration instructors and clinical supervisors.


Assessing the educational needs of medical record personnel.


Continuing education:another source.

Continuing education:another source.


The expanded role of the health record practitioner: health information specialist.


National health insurance and the single specialist. The factors affecting medical economics in the future will necessitate not only changes in existing systems of medical care, but even the implementation of new systems.


A pre-empirical approach to assessing the need for a medical record administration education program.


Employee separation.

Employee separation. The first of a two-part article dealing with an effective employee separation process and its maximization as a management tool through interview feedback.


Use of generic outcome screening criteria.


Federal Privacy of Medical Information Act.


Analysis of economic performance in medical group practices: 1. executive summary.


Peer review for the medical record professional.


Inservice skills and microteaching at the University of Mississippi Medical Center.


Independent study at the University of Tulsa.


The development of medical records in Jamaica.


How do you solve problems?

How do you solve problems?


Medical documentation and literature.

Medical documentation and literature.


Transactional analysis: an effective management tool for medical record practitioners.


U.S.P. laboratory-medical product problems report.


'ACCESS' to time and cost savings.

'ACCESS' to time and cost savings.


Final classifications set for ob-gyn devices.


One dealer's new 'product'.

One dealer's new 'product'.


Doctors contest ACS screening advisory.

Doctors contest ACS screening advisory.


The major vectors affecting health care in the 1980s.


The Kottar experience.

The Kottar experience.


The Raigarh-Ambikapur experience.

The Raigarh-Ambikapur experience.


Unemployment compensation.

Unemployment compensation.


Feds predict spending spree on newest breeds of scanner.


Political gains, grassroots problems: Jim Sammons' AMA.


No Monday wash-day blues at Community Hospital Services.


Planning for health service delivery.

Planning for health service delivery.


Financial consulting.

Financial consulting.


Building codes: conflicting requirements can be costly.


The Berhampur experience.

The Berhampur experience.


Group insurance programs.

Group insurance programs.


Michigan Hospital Association Mutual Insurance Company.


A plan for developing rural hospital shared services.


Group purchasing: a successful cost containment tool.


Laboratory fume hoods.

Laboratory fume hoods.


Private sector holds health cost curb key.


Prior authorization cuts hospital costs.


NHI debate moving right: ins. lobbyist.

NHI debate moving right: ins. lobbyist.


Health companies advised to start educating public.


N.J. hospitals using malpractice facility get $7.2 million refund.


Study finds cancer cover expensive.

Study finds cancer cover expensive.


Inflation in the examination room--Part 2.


Health ins. for all said U.S. priority.

Health ins. for all said U.S. priority.


See HMO enrollment tripling by 1990.

See HMO enrollment tripling by 1990.


1979 health figures: Prudential continues hold on total premium title.


Indisposed to medicine: the women's self-help movement.


Unkept promises: discrimination continues in health care.


A small computer as management and documentation tool.


Laboratory medicine in the People's Republic of China. In August 1979, 12 U.S. laboratory scientists visited the People's Republic of China in an attempt to introduce Chinese physicians and laboratorians to developments in laboratory medicine not yet known or understood in China. The author of this article, one of the group of visiting scientists, recounts the experience, and thus draws an interesting comparison between laboratory medicine in the United States with that in China.


International standards: their increased importance to the United States. The recent approval of the Multilateral Trade Negotiations Standards Code and subsequent U.S. Trade Agreements Act of 1979 have caused international standards to assume an increasingly important role in many countries. A review of these recent initiatives, and an explanation of how they will impact on the National Committee for Clinical Laboratory Standards, are presented here so that pathologists will understand the developments that are taking place on the national and international scenes.


Strategy space: personnel and the law.

Strategy space: personnel and the law. Government regulation is a source of many management headaches, but it has also broadened personnel's field of expertise (and consequent influence). According to Dr. Greenlaw, human resource practitioners would be well advised to learn their "strategy space boundaries" for complying with legislation, because it is this sort of pro-activity that can make and keep personnel a line function.


Preventive-maintenance techniques for staying union-free. Maintaining union-free status is a matter of maintaining credibility with your employees in five key areas: management development, employee training, promotion, compensation and benefits, and communications. The latter two concerns are particularly stressed by Dr. Rand in this low-cost, high-return strategy.


The politics of regulation: understanding the regulatory complex. A look at the federal regulatory process--its cost and benefits, its effectiveness--and alternatives to present regulatory concepts.


An interpretive review of the federal Uniform Guidelines on Employee Selection Procedures. This article clarifies the complex implementation process of the federal Uniform Guidelines on Employee Selection Procedures.


Clamor over recertification continues.

Clamor over recertification continues.


Make costly physicians accountable.

Make costly physicians accountable. Physicians make the majority of decisions about the type and quantity of medical care, but cost-sharing mechanisms intended to control costs place the burden upon the patient. This article proposes a variety of mechanisms for placing this burden upon the small group of physicians identified as being excessively costly.


Danger seen for future of CMHC movement.


Psychiatry and the law--end of an affair?


Optimal ordering policies for continuous review perishable inventory models. This paper extends the notions of perishable inventory models to the realm of continuous review inventory systems. The traditional perishable inventory costs of ordering, holding, shortage or penalty, disposal and revenue are incorporated into the continuous review framework. The type of policy that is optimal with respect to long run average expected cost is presented for both the backlogging and lost-sales models. In addition, for the lost-sales model the cost function is presented and analyzed.


How to plan a special event.

How to plan a special event.


Psychiatry and medicine: partners in primary care.


Medical benefits from the space program.


Integration of primary prevention into social work practice. Although much has been written about the concept, primary prevention has not been integrated into social work practice. The author discusses factors that might move the profession toward adapting this concept and discusses as well those that inhibit its integration.


Forecasting demands for inpatient services in a large public health care delivery system.


Health care programs for scattered populations. Health care for scattered populations is discussed. An optimal system applying current technology is described emphasizing the economic supportability of such a system. This is accomplished by basing the system on health auxiliaries and middle level health personnel who have undergone problem oriented training and who receive regular supervision. The Alaska Native Health Program is described in detail. Several other health care systems in use in sparsely populated areas of the world are reported on. Emergency care as a particular and essential aspect of any health care program for isolated populations is discussed. Finally future trends including current experiments utilizing satellite technology are reported on.


Management briefs--hospital management companies.


Physician cost containment...the next hurdle?


Screening tests to plan preoperative and postoperative respiratory therapy.


Amniocentesis: Pandora's box.

Amniocentesis: Pandora's box.


Dental public health.

Dental public health. The dental profession has prime responsibility for the care of oral health problems in the U.S. Medicine has essentially relinquished responsibility for that part of the body. Dental public health primarily evolved from within the dental profession and it is unique in that a special area in public health was created to address the problems of a particular part of the body. Although one may not think of the major dental diseases--dental caries and periodontal disease--as particularly serious ones, the magnitude of the problem, as evidenced by the universality of the diseases and the extensive levels of untreated pathology, results in a public health problem of major proportions. The field has been expanding in scope and complexity with more emphasis being placed on the total dental care delivery system and its impact on oral health status. The concept of oral health has a very different meaning and value for people in different cultures and socio-economic classes. The prevalent philosophy in the U.S. places the prime responsibility for dental health on the individual.


International medical equipment/Israel.

International medical equipment/Israel.


The blood pressure equipment market.

The blood pressure equipment market.


How does self-help work?

How does self-help work?


Commercial hospital linen versus rental service.


Hospitals are saving more than lives--the Texas voluntary effort: productivity must be increased.


Kill-O-Watt energy conservation tips: a multi-hospital energy conservation program.


Outside consultants: the pros and cons of hiring them.


Beyond coping.

Beyond coping.


The law and multi-hospital systems.

The law and multi-hospital systems.


Multi-hospital systems: where they've been, where they're going.


A not-for-profit perspective on multi-hospital systems.


A penny saved: non-duplication of services.


Santa Rosa Medical Center: how one religious multi-hospital system operates.


Harris County Hospital District: a quasi-governmental approach to multi-hospital systems.


Cooperate to communicate.

Cooperate to communicate.


Supervisory training without a supervisory trainer.


The demand for health services in Texas.


Hospitals are saving more than lives--the Texas voluntary effort: alternate delivery systems.


Getting the word out: publicity and promotion.


Medical record consultants: valuable members of the small hospital team.


The Health Systems Agency and Certificate of Need.


Big business moves into nursing homes.

Big business moves into nursing homes.


Network for spinal cord care planned.

Network for spinal cord care planned.


Agencies experimenting with fringe benefits: four VA hospitals planning compressed workweek test.


Discrimination, poverty described as co-repressors of health care.


Some refugees suffer contagious diseases.


The effective use of the retired volunteer.


Volunteers key to mental health center's philosophy.


Going up? A look at your upward mobility potential.


Hospital cost containment: views of Virginia congressman David E. Satterfield, III.


'Project Health' serves medically indigent through prepaid health plans and private physicians.


Pattern of black hospital closings interrupted as Richmond community revitalizes old hospital in new plant.


Paying for preventive care: why change is needed.


Role of the occupational health nurse in industry.


Surprise and sense making: what newcomers experience in entering unfamiliar organizational settings. Growing disillusionment among new members of organizations has been traced to inadequacies in approaches to organizational entry. Current directions of research on organizational entry and their limitations are described, and a new perspective is proposed. The new perspective identifies key features of newcomers' entry experiences, including surprise, contrast, and change, and describes the sense-making processes by which individuals cope with their entry experiences. Implications for research and practice on organizational entry are drawn.


Board power and organizational effectiveness among human service agencies. This study examines the importance of an externally powerful board of directors to the effectiveness (ability to attract scarce resources) of 46 human service agencies operating within the same community. Traditional assumptions regarding the importance of a powerful board were supported when effectiveness was operationalized using static measures of funding but were not supported when dynamic measures were used.


Establishing relationships in health care facilities.


Recreation services in health care facilities: a collaborative approach.


Administrator expectations of the food service manager.


Elder care in Sweden--a quick look.

Elder care in Sweden--a quick look.


Enhancing the patient's environment.

Enhancing the patient's environment.


The 1980 AIA Honor Awards: a hospital achieves rare levels of design and amenity.


The 1980 AIA Honor Awards: 'calm excellence' in a retirement housing complex.


In earthquakes, failure can follow form.


Trends in allied health education for the health care team of tomorrow.


Employment differences of baccalaureate and associate degree graduates from allied health education programs.


The equality of women's jobs in the allied health professions.


Communication of information to the aphasic patient and family.


Client-centered planning: implications for training health professionals and patient counselors.


An essay-type method for evaluating knowledge of interviewing procedures.


The impact of the allied health professions on health care delivery.


A therapeutic art session with rapevictims.


The decisions pharmacists make.

The decisions pharmacists make.


The foreign pharmacy graduate: the displaced pharmacist.


Electrical safety.

Electrical safety.


'500' crowds challenge MD's.

'500' crowds challenge MD's.


Huge cost savings foreseen for Blues' two new programs.


Hospitals enter the 'wellness' business.


Tornadoes batter Nebraska VA hospital.

Tornadoes batter Nebraska VA hospital.


Physicians and clergymen cooperate at Indiana counseling center.


Running a VA laundry: some similarities, some differences.


Building a better linen usage system.

Building a better linen usage system.


The well-being of design quality in the health-care world.


Finding opportunities in health-care construction.


Sydney raised funds to keep its laser.

Sydney raised funds to keep its laser.


Death, dying and patient care: the patient and his family.


Patients in casualty--Part 1.

Patients in casualty--Part 1.


The effective use of boards.

The effective use of boards.


Current system OK--AHA.

Current system OK--AHA.


Saudi centre slammed.

Saudi centre slammed.


A California county tries running an HMO.


Media center in Peru needs your help.

Media center in Peru needs your help.


College influences education and art of surgery in Chile.


The College's role in Australia.

The College's role in Australia.


Greece: a new chapter in the making.

Greece: a new chapter in the making.


Hospitals can require liability insurance.


The goals and activities of the International Relations Committee.


Some reflections on the College's international role.


Four California hospitals convert to computerized dictation.


Why and how business uses temporary help.


Food and Drug Administration-Redesignation of the Department of Health, Education, and Welfare as the Department of Health and Human Services. Final rule. The agency is amending Chapter I of Title 21 of the Code of Federal Regulations to reflect the redesignation of the Department of Health, Education, and Welfare as the Department of Health and Human Services.


Getting ready for the appraisal interview.


Drug Enforcement Administration--Records and reports of registrants; central recordkeeping permits. Final rule. This rule amends 1304.04(a) of Title 21 of the Code of Federal Regulations by eliminating Central Recordkeeping Permits but still provides a means whereby qualified registrants will be able to keep certain required records at a central location. The amendment will establish a simplified notification system in lieu of requiring a central recordkeeping permit necessary under current regulations.


Public Health Service--Information regarding requirements for health maintenance organizations. Correction notice: information regarding requirements for qualified health maintenance organizations. This notice corrects an error made in a Federal Register notice with respect to information regarding requirements for health maintenance organizations (HMO's).


A national voice for women's health concerns. The NWHN (National Women's Health Network) is a nonprofit organization representing more than 100 health groups in the U.S.; the network serves as a communication and action network for the Women's Health Movement, and publishes a bimonthly newsletter to disseminate critical information on women's health issues.  The network focuses much of its activities on issues of safe contraception and legal abortion, and against sterilization abuse, and against the use of contraceptive methods, such as the injectable Depo-Provera, which are of quesblonalbe safety, and are mostly administered to minorities, poor, mentally retarded or institutionalized women.


Life safety codes: over-regulated or over-designed?


Heart-attack victims leave the hospital earlier as doctors learn to assess damage, predict risk.


Economics of hospital management attract institutions to that group, analysts find.


Our sickness care system.

Our sickness care system.


Calif. investigates medical claim fraud.


Law reform survey--Part 1. Law reform and you: your verdict's in--criteria for determination of death.


The impact of collective bargaining.

The impact of collective bargaining.


Longueuil clinic runs on oiled wheels.

Longueuil clinic runs on oiled wheels.


Care of the patient in the x-ray department.


Relating to the patient.

Relating to the patient.


The new SI units--problems of conversion.


Clinical education--who needs it?

Clinical education--who needs it?


The Canadian Association of Medical Radiation Technologists: letters patent, by-laws, rules and procedures.


Statistics Canada: radiological technicians.


Twenty-eight Annual Welch Memorial Lecture: "Radiology management in the 80's".


The provincial role in the Canadian welfare state: the influence of provincial social policy initiatives on the design of the Canada Assistance Plan.


Should vendors be trapped in fund-raising efforts?


It's called SAVE--and it does! Selective supply monitoring.


Product evaluation--standardization--value analysis.


The hidden barriers to team building.

The hidden barriers to team building.


'Systematic' order entry methods.

'Systematic' order entry methods.


Systems analysis: the health care delivery system in the United States today.


It makes dollars and sense to use BEEP.

It makes dollars and sense to use BEEP.


MSI--a new homework assignment.

MSI--a new homework assignment.


Systems analysis: an approach to the care of heart disease and stroke--a practitioner's view.


Systems analysis: motivational aspects of multiphasic screening.


Cost allocation for LTC facilities.

Cost allocation for LTC facilities.


Administration/On medical benefits.

Administration/On medical benefits.


Controlling therapeutic diets.

Controlling therapeutic diets.


Cherokee Lodge story: at home in Kansas, the dream comes to life.


Management of records.

Management of records.


Canada/subsidies and high interest.

Canada/subsidies and high interest.


Leader Nursing Center: the goal is rehabilitation and home.


Dietetics/patients plan the menus.

Dietetics/patients plan the menus.


The garden: producing their own food in Nebraska.


Psychiatric care in a nursing home.

Psychiatric care in a nursing home.


Retention of tax records.

Retention of tax records.


Confidentiality and the law.

Confidentiality and the law.


Canada/accreditation and the critics.

Canada/accreditation and the critics.


Nursing/billing for supplies.

Nursing/billing for supplies.


Disaster checklist for PR.

Disaster checklist for PR.


Health care needs political action.

Health care needs political action.


Preventing nurse 'burnout': "assertiveness training' can be cost-effective.


Fixed unit assignments for respiratory therapists cuts length of stay, costs.


Public awareness campaign.

Public awareness campaign.


Hospital sets up public relations effort to encourage pre-admission registration.


Contracting with HMOs.

Contracting with HMOs.


Storage and retrieval of radiology records enter the computer age.


Costs can be reduced when hospitals ask the right questions.


Problems in Wisconsin.

Problems in Wisconsin.


Trends in clinical pharmacy in Spain.

Trends in clinical pharmacy in Spain.


Who takes the risk? A variety of methods are available for financing the health care plan.


The application of a freeze-microwave thaw technique to central admixture services. The establishment of a centralized, intravenous solution/admixture drug program in a hospital enhances the quality of patient care. Costs for personnel, equipment, and space have constrained the growth of such a service in the past. A method of preparation for admixture units, which capitalizes on the economics of volume and employs personnel at levels of training consistent with need, is proposed. This technique, utilizing freezing, long-term storage at -20 degrees C, and thawing by exposure in a microwave oven minutes before intended use, surmounts the real and perceived difficulties in many planned or existing admixture programs. A strong element of prospective quality control can be introduced. Where demand is insufficient to justify a separate activity, cooperative arrangements among hospitals will bring all the advantages of central admixture to each. It appears that reductions can be made in the pharmacy hours devoted to admixture. Waste of any unused, reconstituted drugs or prepared units that were not administered may be diminished. Thus, there may be substantial savings for existing admixture programs, if the technique described is adopted. The ultimate form of implementation in each institution, as always, is dependent upon the special "personality" of the hospital.


Group life and health coverage in Brazil.


Emergency medical services in the United Kingdom.


Jump crews: an approach to rural emergency care.


EMT-P-operated motorcycle rescue, a preliminary note.


A study of cardiopulmonary resuscitation technical skill retention among trained EMT-A's.


The new standards for cardiopulmonary resuscitation and emergency cardiac care.


House staff knowledge of blood component therapy: an evaluation. It has been documented that most transfusion errors are either administrative or clerical. It is necessary to ascertain if those responsible for transfusing patients have the knowledge to do it properly. Since house staff are responsible for the proper administration of blood components at many teaching hospitals, a group of pediatric interns and residents were given a short examination to measure their knowledge of transfusion practices and to identify when, during their training, this knowledge is obtained. Transfusion techniques, inspection of blood bag labels, compatibility, and transfusion reactions were covered in the exam. It was found that the knowledge of transfusion therapy is learned by experience and that many house staff members have an adequate knowledge of present-day transfusion practices.


Evaluating continuing education: a focus on the client. This article presents the evaluation methodology used in an NIMH funded continuing education project for mental health professionals. The 96 participants who completed the course in three distinct cycles came both as work teams from agencies and as individuals and had potential impact on 1700 staff and 6913 clients. Forty-eight quantifiable and two qualitative dependent measures were used to assess participants' perceptions of the course, knowledge and attitudes, clinical behaviors as reflected in work environment and ward atmosphere, and impact on client status. A controlled experimental design with pretest, posttest, and follow-up data collection points was planned. Problems encountered and evaluation findings suggest the need for different types of evaluation strategies.


An educational program for psoriatics: an evaluation. Patients with psoriasis referred to the Dermatology Service at Women's College Hospital and satisfying certain criteria relating to percentage body involvement, age, and the absence of serious coincident conditions were assigned at random to three weeks of day care and education at the Psoriasis Education and Research Centre (PERC) or to the Dermatology Service at Women's College Hospital (WCH) for normal hospital care. On admission, all study patients received normal history and physical examinations and were photographed by a standardized procedure that provided an accurate estimate of type and extent of body involvement. A functional history was taken from PERC patients that provided information concerning their ability to cope at home, at work, and socially; the extent and appropriateness of their self-care practices; and their knowledge concerning the pathophysiology and etiology of psoriasis and the names and actions of the medications they were using. Individualized patient education programs were designed with reference to the medical and functional information and implemented in the three weeks of day care. Photographic assessment and the functional history were repeated at three weeks, six months and twelve months. Hospital patients were reassessed at six and twelve months and a functional history was taken at six months. The functional status of PERC and hospital patients was compared at six months. The results of this study reinforced the belief that in the case of psoriasis, education coupled with treatment is more effective than treatment alone.


Antibiotic utilization monitoring--study and review in a Canadian teaching hospital. Patients receiving gentamicin, cephalosporins and penicillinase-resistant penicillins were monitored by pharmacists in a 536-bed university hospital. Of the 217 cases monitored 56% were considered to be rational therapy, 34% were irrational therapy and 10% were questionable. The guidelines used for evaluation of cases were The Audits of Antimicrobial Usage. Guidelines for Peer Review, Kunin and Efron 1977. Treatment was the indication for antibiotic use for the remaining 32% of cases. Sixty-seven per cent of prophylactic therapy was considered to be irrational.


Health education evaluation: an alternate research paradigm. A major disappointment with educational evaluative research in general, and health education evaluation in particular, is all too often outcome of "no significant difference" or "no effect." Reviewing the evaluation literature one finds experienced investigators such as Donald Campbell, Marcia Guttentag, and Carol Weiss lamenting the fact that educational programs persistently fail to uncover statistical differences. This problem continues to plague evaluators whose experiential evidence indicates that the program may have produced some very desirable results. Thus, the traditional methods of evaluation are increasingly being called into question. Evaluators are presenting theories to explain the "no effects" phenomenon and alternate methodologies are being proposed in the literature. This article suggests that health educators not only acknowledge the existence of this dilemma, but develop a working knowledge of alternate or qualitative data methodologies, their possibilities, and their limitations, thus encouraging the evaluation of those health programs which have traditionally been classified as undoable.


Residencies in review.

Residencies in review.


DRG concept generates mixed reaction in hospital industry as research continues.


Usefulness of case mix systems as a tool in hospital management must be determined.


Want to get your AHR complaints heard? One "SHUR" way--tell your congressman.


Advice to hospitals: prepare for some sort of reimbursement system change.


Hospital's solicitation rules involving unions should consider concerns of courts.


Congressman's opinion: return balance and common sense to the regulatory process.


HCA-managed hospital votes tax cut; finances improved.


New ways to profit from a feasibility study. Contrary to popular opinion, a feasibility study should do more than simply indicate a "go/no-go" decision says this author. What it can do is measure how an institution can go about raising those big dollars.


Commentary--medical technologies: a perspective of the Carter administration.


Capital campaign basics promise high visibility. For an organization to conduct a well-supported, successful capital campaign, there's more required than a willing spirit and an institutional need. Dedicated volunteers, an enthusiastic constituency, professional advice and a detailed feasibility study before a campaign is launched are the necessary components.


Lutheran Medical Center: a case history of how sprinkler option provides design flexibility and can save money.


Interview: Eli Ginzberg. Interview by Robert Spanier.


Hospice--What is it? What is its future?


Dawson Report: sixty years after the high hopes of 1920. Nearly everyone has heard of the Dawson Report although few have read it. Unobtainable for many years, its historical importance was recognised when the King's Fund reprinted it in 1950. It has been described as 'the parent of all regional schemes of health services,' with an influence extending far beyond Britain. Although it was shelved by the government of the day within a few weeks of publication, it can now be seen as a powerful influence on the thinking that went into the creation of the NHS.


Pharmacists prescribe drugs in pilot project.


Precedents for establishing district health authorities.


Legal problems facing the internist.

Legal problems facing the internist.


Centres of excellence.

Centres of excellence. The present Government may not be enthusiastic about health centres. But Dr Joyce M. Watson, of Glasgow University Department of General Practice and based at Woodside Health Centre in Glasgow, writes with enthusiasm of their advantages for the practice of medicine and the care of patients.


New hospital assistance plan begins with $15.4 million in New York.


Dawson Report: the centres of discontent. In many respects health centres have done more harm than good. The primary health care teams, which health centres were supposed to foster, have generally failed to materialise. These are among the saddening conclusions of research described by Dr J. Gerald Beales, formerly of the University of Bradford Management Centre and now a research fellow in the department of rheumatology, University of Manchester Medical School.


Dawson Report: design for the future...

Dawson Report: design for the future... The Memorandum on Designs for Health Centres, printed as an appendix to the Dawson Report, described three types of health centre, of steadily increasing size and complexity. We print here the description and plans for Type 1, the simplest. The plans, drawn for the consultative council by an architect, C. H. Biddulph-Pinchard, were not intended to be used as standardised models, but as suggestions to be modified in the light of local conditions and the peculiarities of the site. Health Centre Type 2 was intended to serve a small town, or a group of small towns or villages, and had twice the number of beds as well as more elaborate facilities generally. Type 3 was very grand, including a ward block with up to 66 beds and accommodation for 35 staff.


Dawson Report: more and smaller theme.

Dawson Report: more and smaller theme. It is possible to consider many of the health centres opened in the last 10 years as 'illness centres' rather than 'health centres'. But Hazel Grayson, research officer, and Dr Raymond Moss, director of the Medical Architecture Research Unit at the Polytechnic of North London, argue that it is where a health centre is, rather than what it is, that determines its success.


Clinical psychology: an independent profession. There are few clinical psychologists, just over 1,000 in the NHS in England and Wales. Derek Thomas, Bernard Kat and Frank McPherson review the profession and argue that it should be organised on a district basis.


Hospital size: manage...be they large or small. In this article R. Banyard, assistant hospital administrator, and M. Gorham, hospital administrator, at the Northern General Hospital, discuss Government statements on the size of future hospitals and relate these to the current debate on Patients First.


Getting more out of purchasing: a purchasing workshop.


Hospital and integrated health services--philosophy and overview.


Six steps to follow in purchasing lab equipment.


Hospital and integration health services.


Group purchasing: It's getting bigger...is it getting better?


The sealed bid--a matter of confidence.

The sealed bid--a matter of confidence.


Hospital and integrated health services--community view.


Progressive patient care.

Progressive patient care.


March of health manpower through plans in India.


Hyatt's management team begins work at Cook County Hospital.


INA proposes HOPE--market-oriented health care program.


British health minister calls for private-public sector partnership at AMI ceremonies.


Changing hospital organization using outside consultants: evaluation of one example.


NME gives priority to recruitment for Saudi project.


Sharing health service capital resources in Scotland.


Career development of administrators for the year 2000--and beyond.


Joint consultation in the NHS.

Joint consultation in the NHS.


Application of administrative theory to hospital operations.


DRGs: the new regulatory strategy.

DRGs: the new regulatory strategy.


Building & remodeling: what you need to know and do before construction begins.


HAMC helps hospital trustees chart long-range planning.


A system for improved ward management.

A system for improved ward management.


The best in hospital architecture.

The best in hospital architecture.


Reorientation of medical education to improve health care staffing.


Hospital pharmacy at cross road.

Hospital pharmacy at cross road.


Chinese Hospital.

Chinese Hospital.


Management arrangements below district level: a framework for analysis.


Quake! San Francisco hospitals join in massive disaster drill that points up weak links in emergency program.


A study on drug usage on inpatients at the Nehru Hospital, P.G.I. Chandigarh.


Spotlight on specialist nurse.

Spotlight on specialist nurse.


Hospital out-patient services.

Hospital out-patient services.


O.P.D.--the peep window of the community morbidity.


Planning issues for the 80s.

Planning issues for the 80s.


Role of the nurse in the delivery of health care.


Terry describes program of environmental sampling.


Hospital in total health care programme.


'Management' by objectives.

'Management' by objectives.


Integration of architectural, structural, mechanical and electrical systems in hospitals.


Hospital infections.

Hospital infections.


Casualty and emergency services.

Casualty and emergency services.


Planning and execution of preventive maintenance in hospital and industry.


Organisation of blood transfusion service in a hospital.


Estate maintenance condition monitoring.


Total nursing assessment of the home care patient.


Levels of knowledge about aging among homemaker/home health aides.


Factors contributing to the reduction of inventories in hospitals.


Maximizing reimbursement sources--one agency's approach.


Primary health care in rural areas.

Primary health care in rural areas.


U.S. Regulatory Council's hospital project--opportunity for change.


St. Elizabeth Hospital responds to Mt. St. Helens disaster.


Implementation of family welfare planning programme.


Defining the "professional" nurse: an issue for providers, consumers. A survey conducted in Georgia reveals that 65 percent of hospital administrators and nursing directors oppose the ANA's resolution to make the BSN the entry-level requirement for professional nurses by 1985. While state nurses' associations and professional groups are formulating their positions, further research is necessary to determine the resolution's implications.


Mercy Center for Health Care Services, Aurora, IL. Benefits fair supplements policy handbooks, statements.


Patient alleges eye and hand injuries after surgery.


Woman argues hysterectomy was unnecessary.


MHA supports voucher system, not new VA hospital.


Labeling theory and community care of the mentally ill in California: the relationship of social theory and ideology to public policy. The practical merit of a labeling theory approach to mental illness is examined and assessed through an exploration of its application in terms of public policy, i.e., community mental health policy in the state of California since 1968. Primary focus is placed on the impact of the deinstitutionalization of mental health services in that state, and the release of former mental patients into the community. Similarities in the fundamental ideological underpinnings of labeling theory, an associated conspiratorial model of mental illness, and contemporary California mental health policy, are presented and examples of policy input by labeling theorists and researchers are detailed. The impact of the California policy on the mentally ill is generally negatively assessed in terms of three major criteria: (1) rehabilitation; (2) reintegration; and (3) quality and continuity of care. The "translation" of several theoretical misconceptions regarding mental illness, caused by putting labeling theory into official policy, is suggested to lie at the root of many of the policy's implementation problems. The uses of social science theory and research are discussed, and caution is advised in the translation and application of social scientific theory and research to public policy proposals and programs.


Court of Appeals upholds denial of interim relief in Hill-Burton lawsuit--one judge dissents.


Tapping the flow of information in a rural region: the example of the smallpox eradication program in Bihar, India.


The rights of charitable organizations and the First Amendment.


U.S. Appeals Court confirms NLRB's authority to classify house staff students, not employees.


Legislation to limit use of tax-exempt bonds unlikely in 1980; flexible financing terms are best precaution.


Regulated utilities' First Amendment rights to "commercial speech" affirmed by U.S. Supreme Court--possible analogies to hospital industry.


HCFA clarification permits some reimbursement of unionizing-related costs; AHA pursues total withdrawal of Sec. 2180.


Health education and nursing: concepts for practice.


Administration's standby gas rationing plan fails to address hospital employees' transportation needs; AHA reminds Congress of 1973 mandate to protect public health.


Knowledge of health information and services in a random sample of the population of Glasgow. A RANDOM sample of adults in Glasgow was surveyed by trained interviewers to determine public knowledge on four topics chosen specifically for each of four age groups. The topics were: Welfare rights and services; Coronary Heart Disease (CHD) and individual action that can reduce risk; The dangers of smoking in pregnancy; and fluoride and its functions and the connections between good health and habitual behaviour.


Effectiveness of one-to-one health education in the home. HEALTH education conventionally takes one of two forms, a mass campaign to the whole population using the media, or an approach to members of chosen at-risk groups, through individual or small group sessions. The following study explores the efficacy of one-to-one education of the whole adult population, at risk or not, by visiting a random sample of them in their homes and giving them information on one of four relevant topics, adapting the style and content to the individual's needs and interests. The survey therefore tests the technique of a flexible, person-orientated approach to health education.


Integration of leprosy control work with general health services as planned in Maharashtra. The current literature on integration of Leprosy Control work with General Health Services has been reviewed. In view of the introduction of Multipurpose Workers' Scheme and an experience in a pilot project, the authors feel that the time of integration of leprosy is ripe. The process of involvement of Multipurpose Workers in the Leprosy Control Programme is being introduced in a manner that ensures adequate supervision by the present Leprosy Control staff during the training period and also subsequently for one year so that the transition from unipurpose to integrated service, is a smooth one. After the successful integration of leprosy, the leprosy staff, after adequate training, can be used as Multipurpose Supervisors.


A study of factors related to rural job preference among prospective nursing graduates. Four hundred and thirty prospective nursing graduates from ten schools and five colleges in India were studied to identify factors related to their preferences for work in urban or rural areas. Seventy per cent expressed a preference for urban work. Significant factors related to rural preferences were: religion and background (rural or urban); type of educational institution (government or non-government); and living in a rural setting during community nursing experience. Of the personal, professional and socio-cultural factors related to rural work preference, the most significant were: accomodation, sanitation and safe water; job availability for spouse, security, and school for children. Of the personal and professional factors, the most important were: continuing education opportunities, job satisfaction, and intellectual stimulation.


Principles of steam sterilization.

Principles of steam sterilization. Moist heat in the form of saturated steam under pressure, is by far the most reliable medium, known for the destruction of all forms of microbial life. Steam sterilisation, therefore, is the most economical, effective and widely used method of seeking sterilisation in hospital practice. This article aims at describing the principle mechanism that makes steam an effective destruction of micro-organisms, the equipment that is most commonly used for the purpose and the practical methods of testing for sterility. The application of these principles, it is hoped, will ensure standardisation and quality control of routine sterilisation practice in hospitals thus, contributing towards the reduction in the incidence of hospital acquired infection.


Late hospitalisation of children: some observations and experience. The author analyses the factors responsible for delayed hospitalisation of children which ultimately accounts for high rate of mortality. The problem becomes significant as 50 per cent deaths of children in hospital occur within first 24 hours of admission. The experiences included in this paper are based on personal observations and studies conducted by B. K. Shrimali at Smt. Patel Paediatric Centre, Government Medical College, Jabalpur (M.P.).


Will the Health Department enforce the law? Will the hospital Patient's Bill of Rights be implemented--or scuttled?


Reaching the child in need.

Reaching the child in need. "Reaching the Deprived Child" is India's theme for the Year of the Child. This paper describes the recording system employed in the Community Health Programme of Christian Medical College, Ludhiana and how it enables us to reach not only deprived children, but those in danger of deprivation, the majority being the children of the socioeconomically underprivileged. Many are nutritionally normal at 12 months but 57 per cent of the males and 75 per cent of the females suffer from malnutrition in the 2nd year, 50 per cent of females having severe malnutrition. The etiology, discerned from a study of the deprived, allowed a preventive approach to be designed for those at risk. Intensive nutrition education is given in the homes, commencing as each baby reaches 5 months, and mothers are taught to feed them on suitable modifications of the food available in Punjab homes. The results in respect of 123 babies who had a minimum of 6 months of this care, are described. Complete compliance was achieved in 82 per cent and in the rest partial compliance was achieved. The nutritional status of these infants, compared with a control group, improved greatly, especially in females in whom the prevalence of normal nutrition rose from 26 to 61 per cent and that of severe malnutrition fell from 50 to 17 per cent. The success of this approach depends on an accurate knowledge of the community since this allows priorities to be selected with clarity and maximum effort to be expanded upon those in greatest need.


Challenge of infant mortality in India.

Challenge of infant mortality in India. The paper analyses the existing constraints in the delivery of adequate health services to children. A strategy for containing the infant mortality due to neonatal causes, diarrhoeal diseases and respiratory infections is presented: suggestions are given for better training of manpower for child health services, continuous supply of drugs and equipment and adoption of the "at risk" approach for identification of children likely to die, without intervention. The question of the adequacy of health services for children in India is examined.  Focus is on the constraints--- budget, quantity and quality of manpower, drugs and supplies, and unrealistic work schedules -- and the leading causes of death.  The funds that have been allocated for children are not in proportion to the seriousness of their diseases or the weight of their numbers.  This situation can be corrected by specified allocation to some programs which require organization.  The shortage of personnel and the inadequacy of their training in child health also needs correction.  The budget provided to primary health centers for drugs and supplies is markedly inadequate, so that for long periods the primary health center staff can only offer advice or prescription.  Finally, the work schedules of some categories of workers seem unrealistic. Good antenatal care is essential, and the treatment of anemia of pregnancy and immunization against tetanus appears to be critical.  Natal and postnatal care in the hands of a trained birth attendant lowers both maternal and infant mortality.  Reduction of mortality from diarrhea can be achieved by concentrating on the education of the public regarding what is clean water and food and the availability of oral rehydration mixture to the community health workers and his or her training in its use.  If community health workers begin referring to physicians all infants with a respiratory rate in excess of 50 per minute, few cases would be missed.  In that most of the deaths occur in grade 3 or grade 4 malnutrition, the community workers and multipurpose workers need to be trained to identify such cases during their routine home visits.


Urban hospital closings in the face of racial change.


Hospice: the rise and implications of a new addition to the health care scene.


Antitrust ruling could affect several health professions.


Expanded programme of immunisation for children. The Expanded Programme of Immunisation for Children (EPI) operates as part of the maternal and child health programme and budgeted under it. It has been assured that there shall be no constraints of finances for it. This programme will become the touchstone to prove the concern and commitment of the medical and health administrators for the cause of child health in the country. This paper deals with the background of the EPI, recommended schedule of Immunisation and Programme for the future.


A study of low birth weight infants in an urban community. The study concerns the problem of low birth weight as seen in a prospectively studied cohort from a South Delhi urban community covering 23,700 families and 1,19,799 population over a four year period from 1969-73. The incidence of low birth weight was 22.9 per cent of which 2.7 per cent had a birth weight of 2000 gms. or less and 20.2 per cent had a birth weight 2001-2500 gms. Maternal height of 140 cms or less and pregravid weight of 35 kg or less were associated with the occurrence of low birth weight infant. The mortality was related inversely to birth weight and the gestation affected the outcome directly. The mortality rates declined sharply in infants of birth weight 2001-2500 gms but was still high as compared to infants of birth weight more than 2.5 kg. The later physical growth was affected by the initial birth weight. The study was conducted under the research project 01-658-2 funded by the National Centre for Health Statistics, 3700 East West Highway, Hyattsville, Maryland-20782, U.S.A. In a 4 year prospective study of all infants born to 23,700 urban families in 9 localities in South Delhi, the birth weight of 22.9% of the 6,026 infants, who were born during the course of the study, was 2500 gm or less.  20.2% of the infants weighed between 2001-2500 gm and 2.7% weighted less than 2000 gm.  The mortality rate for the low birth weight infants throughout the perinatal, neonatal, and infant period was higher than for the normal birth weight infants; however, there was a sharp decline in mortality for the group which weighted 2001-2500 gm at birth when compared with the group which weighted 1501-2000 gm.  Moraltiy for all birth weight groups was 2-4 times higher for births with a gestation duration of less than 37 weeks compared to those with a gestation of more than 37 weeks.  Low birth weight affected later physical growth.  24 months after birth, the weight of infants with a birth weight of 1500-1750 was 7.8 kg and their length was 76.0 cm.  For infants with birth weights of 1750-2000 gm the respective measurements were 8.1 kg and 76.9 cm.  For infants with birth weights of 2001-2250 gm, the measurements were 9.0 kg and 77.3 cm, and for the 2251-2500 gm infants they were 9.5 kg and 79.5 cm.  Low birth weight was associated with 1) extreme maternal age; 2) maternal height of 140 cm or less and a pregravid weight of 35 kg or less; and 3) maternal anemia.  The study was conducted from November 1969 to March 1973.  All married women who were located in a house to house census were followed up every 2 months, and those who became pregnant were then followed throughout their pregnancy.  The infants who were born to these women were examined during the first for the next 2 years.  Tables show: 1) birth weight by maternal age, parity, height, weight, and hemoglobin; 2) perinatal neonatal and infant mortality by birth weight group and by birth weight group according to gestation duration; and 3) weight, height, and head circumference of infants at periodic follow-up for 24 months after birth for each birth weight group.


A study of combustibility of wastes of two hospitals for determining disposal by incineration. Determination of quantity, quality and characteristics of the wastes of two hospitals located in the same sector of a class B city was undertaken to review the present dumping method of disposal. On an average 1,424.71 and 224.6 kgs. of five types of wastes as per the moisture content were found daily for seven days in these two hospitals of 1000 general beds, and 600 long stay beds for chest tuberculosis and other Cardiothoracic diseases respectively. The wastes of first hospital had higher combustibility due to its sprawling nature and activities for general patients than that of the second multistoreyed hospital treating special cases. A combustibility analysis of hospital wastes would help to decide whether to adopt incineration for disposal.


Integrated child development services.

Integrated child development services. Highlights the objectives, purposes and functioning of the Integrated Child Development Services Schemes in India, a package of services to children below 6 years of age, pregnant women, and nursing mothers.  An initial 33 experimental projects (in urban slums, tribal blocks and community development blocks) were formed in 1975-76.  Evaluation of these was being undertaken, but on the basis of interim reports an additional 67 projects were approved for 1978-79.


Social aspects of health care in Igbo-Ora, Nigeria. The philosophy and aims of a health care scheme in Igbo-Ora, Nigeria, are outlined. Some of the problems related to creating a data base from which work can proceed are set out and discussed. Social factors are mentioned, and attention is drawn to the need for seeing health problems against general settings specific to a given area rather than measuring upto some abstract or "scientific" standards. The uncharted ground in many Third World practices make this particularly important.


Quality of medical care by central government health scheme--a study. This study reports findings on the time spent by CGHS medical officers per patient in different medical care activities for 2,115 patients, as obtained by time study technique. This study was conducted during the year 1976-77. The average observed time spent by the medical officer per patient was found to be 117.15 seconds per patient. The medical officers elicited only main complaints without asking past and family history in 84.44 per cent of patients and the average time spent on history taking was 42 seconds per patient which also included examination of identify card, recording of name, age and sex of the patients. Physical examinations were conducted in only 23.88 per cent of patients and the time spent per patient was 45.93 seconds. The advice for investigations was imparted in 2.60 per cent of patients, though the facilities for routine laboratory examinations were available in the dispensaries. Advice to the patient regarding dietary instructions and general advice was exclusively given in only 5.20 per cent of cases whereas the family planning/health education advice to the patients was given only in 0.76 per cent of patients. The medical officers are aware of the inadequate quality of medical care provided to the beneficiaries and they felt they should at least spend 6.83 minutes for an old patient and 12.42 minutes for the new patient. Probably they are not able to do so because of long queues in the dispensaries during peak hours. Hence, to improve the overall medical care and provide comprehensive care to the beneficiaries it is suggested that the medical officers can be given certain beneficiary population and made responsible to them.


Informational and documentational needs for education and training for health and family welfare--"para-professional and auxiliary". In this paper, the author stressed the needs for a central arrangement for acquisition, exchange and dissemination of scientific information in the field of health and family welfare so as to increase the efficiency and effectiveness of planning, administration and evaluation of health and family planning programmes and also to carry out research when needed. The proposed arrangement in the form of a documentation centre must collect information on health care systems as their main functions so that the information and documentational needs for the education and training of health personnel are rationally developed in the context of present and future health needs and demands.


Quality and effectiveness of PHC level class room training under MPW scheme. Government of India have prescribed duration, curriculum and trainers for training of PHC field staff under multipurpose workers' scheme. The extent of implementation was studied in three States. Quality of training was also observed and its impact on knowledge and understanding was determined by comparing pre- and post-test scores on different subject areas. Centralised strategy for class room training with HFWTC as the venue was found to offer several advantages. By and large, Government of India's prescribed curriculum had been followed. Deviation had taken place mostly in the type of trainers. Topics and their sequence were well covered. There was, however, little use of training techniques to promote understanding and participation. In particular, there was lack of teaching aids at PHC level class room. Male field staff showed greatest need and profitted most from the training. Knowledge of maternal and child health and family welfare was least in both male and female staff before and after the training. Administrative factors affecting MO of PHCs as trainers were also determined. This is second in the series of papers based on the project findings.


Pride fosters motivation.

Pride fosters motivation.


Improving relations with medical staff.

Improving relations with medical staff.


Sampling: how to fix the odds--Part 1.

Sampling: how to fix the odds--Part 1.


Philadelphia sans PGH.

Philadelphia sans PGH.


NY nurses hit the bricks.

NY nurses hit the bricks.


Early physician intervention saves hospital's resources.


Procedures for decontamination, management of toxic waste.


Risk control allows hospitals to share insurance profits.


Structured settlement can save hospital monies, benefit patient.


Recirculation air creates xylene intoxication hazard.


Precautions followed by personnel involved with the preparation of parenteral antineoplastic medications. There have been no guidelines published for precautions to be taken by personnel preparing parenteral antineoplastic agents. A questionnaire was prepared and mailed to all of the Comprehensive Cancer Centers in the United States for their opinions on this subject. A response rate of 84% was achieved. The major concerns of the respondents were 1) the local effect from spillage of antineoplastics on the skin and 2) the possible inhalation of solutions vaporized during preparation. On the basis of the responses to the questionnaire, it is recommended that all hospitals evaluate their procedures for preparing antineoplastics and take appropriate precautions to protect their personnel from any potential adverse effects from the medication prepared.


1980 Lilly hospital pharmacy survey: preliminary report.


The handling of antineoplastic drugs in a major cancer center. It has long been known that many commonly used antineoplastic agents are carcinogenic. Yet most health care professionals take few precautions, if any, when handling these drugs. Recent findings suggest a possible hazard to personnel as evidenced by increased mutagenicity of urine of nurses exposed to anticancer drugs during preparation and administration of doses. Although more study is needed to determine the significance of these data, it would seem prudent to take measures to prevent any unnecessary exposure to these drugs by those preparing and administering them. The policies and procedures at the Memorial Sloan-Kettering Cancer Center require that chemotherapeutic drugs be prepared in a vertical laminar flow containment hood by personnel wearing sterile disposable gloves. Chemotherapeutic agents are specially labeled to ensure segregated disposal of waste, which is subsequently incinerated.


Evaluation of two sterility testing methods for intravenous admixtures. The Addi-Chek Quality Control System (Millipore Corporation) and Ivex-2 Filterset (Abbott Laboratories) were evaluated to determine their effectiveness, applicability, and cost as part of a pharmacy quality-control program. Each method was tested using 50 solutions, 25 of which had been contaminated by inoculation with one of five micro-organisms; the other 25 solutions were used as controls. Aseptic technique was used, and procedures were carried out in a laminar air flow hood. Contaminated solutions were blinded from the person performing the tests. Addi-Chek detected contamination in all the inoculated solutions and in three of the uninoculated solutions. The latter may have been a result of adventitious contamination during the testing procedure. Ivex-2 detected contamination in 24 of the 25 inoculated solutions; no other contamination was found. The effectiveness of the methods in detecting low-level microbial contamination appears comparable. Both methods have been shown to be useful in the pharmacy setting, but Ivex-2 could be used to test for contamination when used as an in-line filter at the patient level. Ivex-2 is less expensive and warrants further evaluation in monitoring for microbial contamination during preparation and administration of intravenous solutions.


. . . And voting, too!

. . . And voting, too!


Competitive market holds key to private health resources.


Food services: careless talk can sink ships.


Food services: garnish is an art to be learned.


Health planning: how the law works.

Health planning: how the law works.


Health planning: the federal perspective.


Health planning: the consumer's role.

Health planning: the consumer's role.


From the inside looking out.

From the inside looking out.


HSA: mockery of democracy.

HSA: mockery of democracy.


State certificate of need.

State certificate of need.


Food services: why use the standard recipe?


How the nation looks at nursing homes.

How the nation looks at nursing homes.


How to save money on utility bills.

How to save money on utility bills.


Legal implications of P.L. 93-641.

Legal implications of P.L. 93-641.


The 1981 health budget.

The 1981 health budget.


Rocking & rolling to the tune of $140,000.


A non-proprietary view: administrator-board communications.


College of knowledge: how much does the resident of your skilled nursing facility really know about the facility in which he resides?


What's wrong with U.S. health care.

What's wrong with U.S. health care.


Businessman, heal thyself.

Businessman, heal thyself.


Food services: portion control.

Food services: portion control.


Odyssey of a comprehensive community mental health center in a voluntary teaching hospital.


A service delivery system for consumer implementation and evaluation.


Rape accusations in psychiatric hospitals: institutional dynamics in crisis.


A comparison of passive and active music reinforcement to increase preacademic and motor skills in severely retarded children and adolescents. Eight severely retarded subjects were each taught two behaviors with contingent music listening (passive reinforcement) and contingent rhythm instrument playing (active reinforcement) to determine which type of reinforcement was more effective. A variation of the multiple baseline design was used in which a baseline condition preceded and followed two treatment conditions, passive and active music. Treatment conditions for each behavior were terminated at criterion or after the subject failed to meet criterion. Criterion was defined as an increase of 25% above the baseline mean for three consecutive sessions. An F test was performed on the sessions to criterion and the behavior frequencies under each reinforcement condition. Results indicated that both passive and active music reinforcement had a positive effect even though no significant differences were discerned between the two reinforcers for either variable. These findings were consistent with the previous limited study in this area.


The effect of music ear training upon the auditory discrimination abilities of trainable mentally retarded adolescents. The purpose of this study was to investigate the effect of music ear training upon the auditory discrimination abilities of 30 institutionalized trainable mentally retarded (TMR) adolescents. Subjects were 15 TMRs enrolled in choir and 15 TMRs who were not choir members. The hypothesis was that music ear training incorporated in choir rehearsals would enhance auditory discrimination abilities, as measured by the Goldman-Fristoe-Woodcock Test of Auditory Discrimination. An analysis of variance revealed significantly more errors in auditory discrimination by the TMR adolescents not enrolled in choir. Results of t tests comparing the scores of TMR choir members to Goldman-Fristoe-Woodcock test norms for the same chronological age revealed significantly more errors by the choir members. However, t tests comparing the performance of TMR choir members and Goldman-Fristoe-Woodcock test norms for normal subjects of the same mental age revealed significantly more errors by normal subjects.


Theories of aging: the difference in orientations.