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This paper deals with the present position of a specialized scientific library, the increase in the number of such libraries, and their development in conjunction with that of the institutes and laboratories to which they belong. It describes the danger for these libraries of too great expansion and the need to restrict themselves to a well-defined area. The different categories of specialized scientific libraries are reviewed, as well as the role of each of these categories vis-à-vis overburdened university libraries. There is an account of the assistance given [by specialized scientific libraries] to university libraries now and in the near future.

The theory of frazil ice formation is reviewed as well as the main factors which cause formations. The methods of forecasting frazil ice and the design and remedial considerations are also included. Although the frazil ice problem has been solved at many sites in Canada, this review summarizes investigations which would not generally be available to Canadian engineers. The paper is accompanied by a bibliography of about seventy items including recent papers from the U.S.S.R.

Read before the Society, 20 May 1966, In the present decade, there are two major factors that can be expected to affect the demand for food in Ireland; the first is the country's becoming part of the European Economic Community, the second is the attainment of the target rate of economic growth aimed at in the official Second Programme for Economic Expansion. When the first of these events comes to pass, Irish consumers will be confronted by a completely new series of retail prices for food, and how they are likely to respond to these prices is the main question that the present paper attempts to answer. In addition, the demand for food on the home market can be expected to depend on the future level of (a) income, (b) population, and the combined effects of these variables on demand is the second question dealt with in the paper.

Summary For over two decades the Punjab Public Health Department, India, had been issuing forecasts of the probable incidence of epidemic malaria based on the method developed by Gill. This method utilises information pertaining to rainfall, enlargement of spleen among school children, economic conditions and the variability of malaria incidence in individual localities recorded in previous years. In this paper the success attained in these forecasts has been assessed and a brief reference made to further work carried out in recent years to improve the method of forecasting. It has been shown that the method so far employed did possess usefulness. Recent work has indicated: a. The existence of periodicity of about eight years duration in the incidence of malaria. b. The existence of association between rainfall in the month of May and the incidence of epidemic malaria in the fall and that c. Contrary to the belief held by Gill, the data bearing on enlargement of spleen in a community do not appear to be of help in providing an adequate basis for the forecasting of epidemics. The Punjab could perhaps claim a unique position in as much as it is in this province that attempts were made to develop and bring into administrative use a method for forecasting epidemics of malaria. In view of the partition of India into the two dominions of the Union of India and Pakistan, the province has now ceased to exist as a single entity. It is, therefore, of some interest to record the stage at which studies on the forecasting of epidemic malaria had to be terminated.

This paper has represented an attempt to summarize the facts pertinent to the development and present status of the District Branch movement that is now progressing within the American Psychiatric Association. Some reflections concerning and suggestions about organization for the effective meeting of local and statewide needs for psychiatry have been offered. The related matter of adjustments between the District Branch and the Affiliated Society has also been discussed and the need for continued liaison with our medical brethren emphasized. It is this writer's earnest hope that he may have stimulated thinking on these matters in some small degree; that constructive and fruitful discussion may follow; that out of collective wisdom flowing from the democratic process, the American Psychiatric Association may continue to maintain an organizational structure that will permit the perpetuation of her status, not only as the oldest Medical Association of National size in North America, but also as the recognize...

Introduction It is proposed in this paper briefly to review the surgical procedure of keratoplasty, rapidly to note the stages of development, to comment on its present status, its possibilities, and its limitations, and to point out in what directions we may expect future progress with suggestions as to how we should best apply our efforts to attain these desired ends. Until recent years the efforts of the surgeon or specialist working in the field of tissue transplantation have been preoccupied with instrumentation, technique, and clinical observation of the patient. This is not to be decried, since it is quite obvious that mechanical improvement in corneal grafting techniques and instrumentation is largely responsible for the present high level of achievement in this area. When, however, we come to interpretation of clinical problems, as for example, "graft sickness," speculation has run wild and there has been relatively little serious or scientific

THE FUTURE role of hospitals in medical care has become a popular topic for endless pedantic discussion. This is not just because of the present and future responsibility of hospitals in the broad spectrum of health care for the people of this country important though this be. Equally important is the fact that the role of hospitals in medical care is to a considerable extent misunderstood by many physicians, hospital administrators, and hospital board members so that emotion and controversy frequently mar what should be a most important and mutually rewarding partnership. Part of this misunderstanding is the result of changes and developments in methods of providing and financing health care during the past few decades. Another factor is lack of mutual education or communication between those concerned in this complex relationship. Furthermore, there is frequently no clear definition or understanding of terminology or the philosophy upon which our modern hospitals and medical practice are organized. It is particularly important at present that there be a clear understanding of the role and responsibilities of hospitals and their relationships to physicians, patients, and the public. Hospital costs are rising rapidly, the total cost of health care to society is increasing, and questions are being raised by management and labor, as well as by representatives of government whether existing patterns in the financing, organization, and production of medical and hospital care should be changed. This nation is one of the few in the world in which voluntary hospitals and medicine combine to provide the great bulk of short-term general hospital care. Our standards are high and our potentialities limitless. However, it is necessary that we clearly understand what we have and where we are going. The quantitative role of the hospital -that of the medical center-is too large a subject to be discussed in detail in this paper. Evidencecontinues to point to the greater concentration of community health activities around the hospital. As diagnostic procedures and facilities increase in complexity and cost, it is logical that they be concentrated close to the hospital where they are essential for inpatient hospital care and thus avoid expensive duplication elsewhere. Physicians are finding it easier

This paper presents an application of Poisson distribution method for managing the optimal number of spare modules of the Croatian airspace surveillance system. Out of a large number of modules and electronic parts in operation, a set of 11 critical modules are identified which have experienced failures and replacements with identical modules in three years history data. Using Poisson distribution for the failure forecasting, maintenance planner can make optimal ordering of the critical spare modules for a following period by which is possible to avoid any backordering, spare module shortage and the most important operational shutdowns. The results were the creation of the Poisson model in predicting the failure rate of radar vital modules for sizing the initial stock of spare modules to be ordered along with other electronic equipment.KEYWORDSoptimization, spare parts, Poisson distribution, forecasting, maintenance, reliability, non-repairable parts

It is currently being proposed that the levels of iron fortification be increased in bread and flour in the United States. Comparable proposals have been repeatedly discussed in Canada. Of interest in considering such proposals are the potential impact of fortification upon a) the coverage of target groups (adequacy of iron intake), and b) the upper levels of intake among these and other groups (danger of excessive intake). The present paper does not attempt to resolve the many issues which have surrounded the iron fortification debate, but an attempt will be made to illustrate an approach to the prediction of the impact of fortification upon coverage of a prime target group, menstruating women. and upon the iron intakes of male adolescents and adults. The data employed’ were drawn from Canadian studies; relevance to the current United States situation can only be inferred.

The author of this paper suggests that the very considerable geographical variations in leukaemia mortality warrant continued investigation. However, studies attempting to relate leukaemia mortality to variation in levels of natural radioactivity might to advantage be confined, for the moment, to areas in which differences in natural radioactivity levels are substantial. The investigation of certain groups of patients exposed to ionizing radiation from medical sources is also important to an understanding of the etiology of leukaemia.There are other groups in which the leukaemia experience is unusual and which might form the basis for further investigation. These include mongolian idiots and their relatives, children aged 3-4 years, children in certain maternal age and parity groups, certain segments of the population of Israel, and persons occupationally exposed to benzol.

This paper consists of excerpts from an address delivered by Dr. Phillips, president of the American Dental Association, April 7, 1959, before the alumni of the College of Dentistry, New York University. The history of dental education is traced, the importance of the integration of dental education with the universities is stressed, and the benefits of conducting research in the dental colleges are cited.

With the increased availability of more potent medications in an affluent society which permits increasing usage each year, the potential repetition of a tragedy similar to that of thalidomide must arouse concern about the future. Efforts by the Food and Drug Administration to prevent this repetition may not be a guarantee of safety. Since these effects frequently are scattered throughout a population, the ability to collect adequate data which may arouse concern is very limited. The authors briefly survey the occurrence of the phocomelia epidemic between 1956 and 1962. They go on to describe how the story might be told in 1974. Using currently available ideas and machinery they show how these may be incorporated into a fully automated hospital information system. It is possible to envision the prevention of such an epidemic by the rapid amassing of information otherwise inaccessible in the hospital record. The facts of the thalidomide story are that the information relating to the increased incidence of phocomelia was present long before the actual epidemic was stopped. The use of a reactive automated hospital information system would overcome this tremendous time lag. The purpose of this paper is to demonstrate a meaningful example of the potential usefulness of the automated clinical record and encourage others to assist in this important development.

The ratio of physicians to general population in California has been approximately the same for many years, the influx of physicians having kept pace with the population trend. For many years California has licensed more physicians than any other state. The five medical schools in this state have been increasing the number of candidates admitted to the freshman class. Attempts are being made to increase the number of medical schools in this state to seven in anticipation of the future growth and medical needs of the population. The heaviest concentration of physicians is as always in the thickly populated areas as determined by the population physician ratio.A study of the detailed statistics presented in this paper should be of interest to all California physicians.

T WENTY years ago, when I first entered the field of public health, I had the good fortune to become an apprentice epidemiologist in the New York State Department of Health. The epidemiologic tradition was very strong in New York at that time; our seniors preferred to be members of the epidemiology section rather than the health officers section of the American Public Health Association, and it was no accident that we were called apprentice epidemiologists rather than health officers-intraining. Public health practice then was oriented to communicable disease epidemiology; among other duties as an apprentice health officer, I visited adults with chickenpox to make certain they did not have smallpox, investigated sporadic cases of typhoid fever and small outbreaks of food poisoning, assisted in immunization clinics, observed public health nurses teach families the care of communicable disease in the home, made contact investigations in syphilis, attempted to convince tuberculosis patients who were hazards to their families that they should a.cc,ept hospitalization, and learned the intricacies of the syphilis and tuberculos,is case registers. The main concerns, of the health departments were wa.ter and milk sanitation, maternal and child health, and the control of communicable diseases, of which syphilis, tuberculosis, and poliomyelitis were the most important. There was a new program of cancer control, but our contact with it at the local level was limited to occasional visits to physicians to obtain further information on cases fo,r the cancer register. During my apprenticeship, I spent 1 month visiting the various divisions and bureaus in the central office in Albany. It was there I learned that a controversy had arisen in the department over the issue of whether public health nurses should do bedside nursing. It wasn't clear who had raised the issue, but apparently there was a great deal of resistance to such an extension of functions of public health nursing in official agencies. At any rate, nothing came of it; during the next few years that I was with the department, I heard no further discussions of this question, and no bedside nursing programs were introduced. As I look back upon that period, I am impressed with the absence of any sense of crisis or uncertainty. There was a lot of work to be done, protecting mothers and children and fighting major communicable disea.ses along established lines, and nobody, or hardly anybody, was asking that agonizing question which preoccupied the public health movement in the fifties: "Where are we going in public health?" The past serenity of the public health movement has been shattered by a curious paradox. The fight against disease has resulted in an increase in disease, or, more exactly, the very successes of public health in preventing disease have created a population which suffers more disease than ever before. This seems inconceivable at first glance, a crude and monstrous joke which bears no relation to reality. Nevertheless, it is true. Public health achieved brilliant successes in preventing infants from dying of diarrheal diseases, mothers from dying in childbirth, and children and Dr. Terris is head of the chronic disease unit, division of epidemiology, Public Health Research Institute of the City of New York, Inc. The paper is based on an address given at a series of regional conferences sponsored by the department of public health nursing of the National League for Nursing held in April 1962.

In the addresses before medical meetings and in the papers in the medical literature today one sees more and more concern over the shortage of specialists certified by the various specialty boards. Many of these utterances imply that this shortage indicates an inadequacy of medical care now available. Our purpose in this presentation is to point out a trend toward the concept that only specialists are qualified to treat patients, to question the validity of this concept and to present a plan to halt or reverse this trend. It is not our purpose to question the importance of highly trained specialists in the treatment of patients: simply to question the necessity of their treating all patients. For convenience of discussion the system of the practice of medicine in which the patient has no choice of physician, in which supervision of the physician in charge of a patient is exercised authoritatively