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During the past decade use of digital computers in civil engineering has progressed in amount of use and in ease of use. The advent of the Problem-Oriented Language (POL) was of tremendous importance to the profession, but the method of implementing processors for POLs was for some time a stumbling-block to the proliferation of the languages. In 1966, the writers (with S. J. Fenves) published a paper describing a new approach to the implementation of POLs, an environment which promised to simplify the production of processors and encourage the creation of POLs for many phases of civil engineering. The environment has now been in use for approximately four years, in various forms, from a prototype batch-mode version to a conversational, real-time, time-share version. The present paper is a progress report on the status of the environment for POLs (both proposed and actual) and the experience gained in this endeavor.

This paper reflects an interest in how interior and landscape sites are connectedin their capacity to exceed or ‘overcome’ architecture and practice conventions of designing, making and use. In professional architectural practice, these conventions are generally treated as distinct and hierarchical steps. This reflects a view of life that is ordered, controlled and deterministic. Referring to ideas that affirm the unpredictable and evolutionary nature of life, I argue for more experimental, improvised spatial practices. I have drawn from Elizabeth Grosz’s writings about space and time to show how we can use change and spontaneous making in everyday life as designing. This has helped me to question how spaces are produced, and the singular design ‘authority’ of the architect or building designer. I have found that working in interior and landscape sites provides more opportunities for unplanned construction connected to the lives of those who inhabit space: opening up architecture and architectural practice to unpredictable forces repressed in professional practice. This paper, part of my doctoral research, explores the conceptual and practical dimensions of experimental interior projects.

One of the major reasons for undertaking empirical research is to influence policy. Cumming's paper falls under that category only since it is obvious that advancing methodology cannot be the reason (see the Drebin critique). Further, the subject matter is so narrowly construed that a more general advance in the discipline cannot be considered a major objective. So, it is important to look at the policy implications of this paper. The research attempts to explain ".. . differing treatment of apparently similar unusual events" and "to assess the criteria in APB Opinion No. 9... as to ... how broadly or narrowly accounting principles (or standards) need to be construed to achieve corporate financial reporting which is essentially free from managerial bias... 'results are then interpreted to draw conclusions and recommendations from this research" (p. 61). Given the title and the quoted objective, it is difficult to draw any other conclusion than that the rationale for the research is an attempt to influence policy. In the interrelationship between academia and practice, this kind of empirical research is greatly needed. In formulating practice policy the profession (through the Financial Accounting Standards Board on the Accounting Principles Board) needs research and data so the subject is certainly apropos. Unfortunately, this entire effort serves to point out the extreme difficulty of research aimed to please the two diverse groups. Drebin devotes his critique largely to the academic areas, while my critique will speak to professional practice.

The physician's important decision-making role in the allocation of medical resources is well recognized. An important part of this role is one physician's decision to refer a patient to another physician for care. Existing research, largely descriptive in nature, has been limited by lack of a clear theoretical and conceptual framework for analysis. The current paper develops and tests a model of physician referral behavior based on exchange theory. Differences in rates of referral among physicians are viewed as a function of the different rewards and costs perceived by physicians occupying different levels of status within a given medical community. The model is tested using data collected from 127 internists in private practice in the northern suburbs of Chicago. Findings are discussed in terms of policy issues and suggestions for further research are indicated.

The paper discusses practical experience of incorporating optimization techniques in the design process. Methods of optimization often assume that a continuous spectrum of solutions is available to the designer, but in practice the engineer is generally confronted with a finite set of discrete alternatives. The ease and merit of applying experience orientated computations with a pre-planned lattice search method is demonstrated. This approach is illustrated through its application to a specific structural element within a building; and the results are compared with those obtained from a direct search method which incorporates an acceleration strategy and which assumes a continuous spectrum. The application of the method to the synthesis of reinforced concrete rectangular service reservoirs is considered. The results and experience gained from the use of this algorithm indicates the difficulties and advantages which designers have experienced in incorporating optimization within the decision process.

The success of many health-related poverty programs in the United States depends to a great extent upon the physicians' willingness to work on a salaried full-time basis rather than to provide the part-time donated medical care of the past. Expressed willingness to serve in such programs is related to “entrepreneurial” and “socially conscious” orientations of medical practitioners. This paper, based on a national sample of physicians, presents evidence that these orientations are strongly present in the medical profession, with rather inconsistently structured attitudes on a variety ofrelated topics. As a consequence, only a small but definable segment of the medical profession shows an interest in active participation in poverty programs.

This paper contrasts present day recruiting practices with the intense aggressive recruiting of a few years ago, illustrates the effect of unethical practices, and acknowledges the graduating engineer’s part in these practices. It emphasizes the need for and the trend toward practices beneficial to the engineering profession and industry as a whole.

Many civil engineers, as they advance in their professional careers, become increasingly involved in technical and general management. The present trend towards quantitative management methods, which makes use of mathematical modeling and similar analytical techniques, is of particular interest to the management-oriented engineer. The paper reviews the educational preparation for management which is supplied through the typical CE undergraduate curriculum, and is made to the current ASCE policy, as evidenced by the ASCE Fellowships in Civil Engineering Management.

The subject of this paper is the relationship of the Academy of Management to the profession of management. Its purpose is to explain some of the reasons for our reorganization within the Academy a...

Engineering basis of coastal protection is discussed in general with emphasis on experience on Dutch seacoast; paper supports shift in old philosophy of protection by groins and seawalls to new philosophy of protection by sand fill.

The APA Task Force on Women was created to study the special issues and problems of women, especially in relation to the practice of psychiatry, and the special concerns of women psychiatrists. In this paper, the author details the specific areas the task force is examining, summarizes the findings of some of the few reports in the literature, and outlines the projects the task force has undertaken.

It has been recognized by economists that economic change and development depend in large part on social change. But the difficulties of constructing a model of social change that is comprehensive enough, yet detailed enough, to be a useful tool for analysis seem almost insurmountable. One way out of the difficulty is to focus on a particular type of change. Such variables as child-rearing practices, motives, and social values and attitudes shape the personality of the entrepreneur and thus have important, if indirect, effects on economic change and development. The present paper traces the changes in these “intervening variables” and the consequent changes in American business practices during the past 150 years, as contrasted to social and economic changes in Europe and Latin America during the same period.

N the past few years, it has become increasingly clear that the concepts, the findings, and the research technology of the behavioral sciences have a definite relevance for the field of public health in general, and for public health administration in particular. The literature reflects the growing relationship between the two disciplines. A number of papers at various professional meetings have already been given on this very topic and, in general, it does not appear unwarranted to infer that the field of public health has not only been receptive but rather hospitable to the behavioral sciences. This is witnessed by the various positions behavioral scientists occupy on the faculties of schools of public health, and the roles they play as permanent personnel of-or as consultants topublic health agencies. One major way in which behavioral science is helpful to professionals in the field of public health and medical care administration is by directly focusing on health care recipients and by making administrators more aware of the values, attitudes, and behavior of their target populations. Thus, for example, behavioral scientists have emphasized that lower-class people, with a value orientation stressing the present, may not as readily accept public health measures that involve daily scheduling, budgeting, and planning for tomorrow. Social scientists have also demonstrated how ethnic groups and persons from different socioeconomic groups may vary in their perception of pain and illness.1 Such individuals and groups will differ in the kinds of assurances or help they seek from physicians or other medical personnel, and they may be more reticent than their middle-class counterparts in asking questions of the physician, or even in simply relating to the physician. In fact, these people may find it more instructive to turn to the nurse or to the pharmacist for specific medical advice. The field of the behavioral sciences, in short, provides a number of empirical descriptions about the beliefs and behavior of the recipients of public health programs. This body of knowledge may constitute one major basis for forging and modifying some of these programs. Whenever it is feasible and ethical to do so, public health agencies may find

This paper poses some fundamental, and therefore naive, questions about the purposes health care delivery systems should serve, and it analyzes the discrepant purposes our current systems do serve. After considering some general propositions from the sociology of organizations, and then some derived propositions bearing specifically on the roles of professionals today, it argues that professional dominance tends to produce results that are dysfunctional in terms of the purposes health care delivery systems should serve, and explores implications of these general dilemmas in the mental health field.

FOR MANY years sociologists have done research on race relations in the United States, especially between Negroes and whites. In the past decade, hospitals and the health professions have also been popular objects of sociological inquiry. But thus far, there has been relatively little study of race relations in health organizations.? Although some attention has been paid to the contribution of low-status hospital workers to the therapeutic process, the extent to which the race of the low-status worker may influence the contribution has not been studied.2 This paper presents some data contrasting patient perceptions of subprofessional low-status Negro hospital workers with patient perceptions of the professional high-status white hospital staff.3 The data suggest that from the patient's point of view (1) Negro aides, orderlies, housekeepers, food service personnel, etc. are more effective in meeting the patients' needs for expressive care than white nurses and physicians; and (2) these individuals' low status, Negro race, and sub-professional affiliation directly contribute to their effectiveness. If supported by further research, these hypotheses would have important implications for the sociology of race relations and for professional practice in patient care. Procedure and Setting The data were collected in a study of the role of the hospitalized patient from the patient's point of view. During the initial stages of this project, interviews were conducted with a sample of patients (N = 85) on several wards at one hospital. In addition to the attending physician's permission, to be included in the sample patients had to be white, American born, between the ages of forty and sixty, must have had

Stimulated by modern management and its emphasis on the planning of process rather than the planning of structure, this paper sets out to consider the process of clinical practice within the context of a medical care system. The frame of reference for this analysis is that of problem solving—considered firstly as problem definition and secondly as decision-making—these operations will be discussed in terms of the necessary basic skills and tasks involved. This will then be followed by considering generally some applications of this job analysis to both eduction and management.

The historical evolution of social insurance and medical care in Brazil is outlined in this paper. A description is given of the gradual expansion of the direct provision of medical services by the social security institutions between 1933 and 1955, after which there was a leveling off period and then a decrease in services in relation to the growth of the number of persons covered. Social insurance now provides barely ten per cent of the medical services used by the beneficiaries; contracts with separate hospitals and doctors account for the rest. Although social insurance has not succeeded in modifying completely the patterns of medical care in Brazil, it has contributed, together with other government activities in the health sector, to a substantial modification of the patterns that existed before the introduction of social insurance. This change has been most noticeable in hospital care, since social insurance has become the single largest financing agency of Brazilian hospitals.

This paper examines the pharmaceutical market and prescription drug costs and consumption in the Federal Republic of Germany. Comparisons are made with the experience of other countries. It is argued that the pharmaceutical market in the Federal Republic is characterized by a relative abundance of pharmaceutical products and, as in other countries, is both limited by an inherently oligopolistic supply structure and modified by physician prescribing habits. The distribution system shows a tendency to supplier-administered prices owing to a noncompetitive retail structure, reinforced by the inclination of the statutory health insurance scheme toward price uniformity. Despite relatively higher promotional expenses than noted elsewhere, these factors are not conducive to the more meaningful price competition observed in some other countries with a more diversified distributive sector, such as the United States, or in other systems where tendencies toward oligopsony or near monopsony, e.g. Sweden and the United Kingdom, may provide some counterbalancing mechanisms aimed at the modification of retail prices. Recent per capita cost development is considered in the light of some cross-national comparisons. It is argued that in the countries studied, depending on the level of development, either a per prescription cost push or a cost increase pull due to increased utilization frequency is prevalent. This distinction would tend to refute the occasionally advocated view that cost increases are determined almost exclusively by increasing utilization, whether dynamically or as a function of time. In the Federal Republic, a relatively high level of utilization constitutes the main factor affecting the total per capita drug consumption cost. Nonetheless, owing to a comparatively lower per item cost, total costs are comparable to the outlay observed in some other countries. Both in the Federal Republic and in other countries with relatively stable utilization patterns, changes in the average per prescription cost may in the long run prove to be the dominant factor in the formation of total per capita costs for prescribed drugs.

The ‘scientific method’ may be defined as a time-tested broad pattern of problem solving which gives efficient results. Many individuals such as John Dewey, have claimed that the scientific method can be used for all problem solving. Others argue that there are many types of problems for which the scientific method cannot be used, particularly for complex human relationships such as those found in politics and sociology. This paper will follow the thesis that the scientific method may generally be applied to all types of problems; and that where the method appears inapplicable it appears thus because of application of the wrong pattern of the scientific method’s triad of patterns of problem solving.

A generalized audit command language (ACL) has been designed in response to recent developments in computer-based auditing and in anticipation of future needs. The syntax of ACL is summarized in this paper with respect to data and model bank audit functions. It is intended to implement ACL in a number of different versions, facilitating explicit and implicit programming by auditors and supporting a variety of audit functions. Various implementation strategies and some of the implications of ACL for teaching and professional practice are discussed as well.

AMERICAN Public Administration as a professional practice and as a field of study has come of age. It possesses clarity of purpose and content. This has been achieved as educators who are and who think as administrators have described the dimensions of the field, as thoughtful practitioners have shared conclusions drawn from experience, and as pioneers from both groups organized a professional society. Although there has clearly emerged an independent field of study and practice, the direct relationship between it and the professional association, the American Society for Public Administration, has been more implicit than explicit. This seems an appropriate time to review some current developments in education and practice and to consider ways in which the professional association can forge a stronger link between them. Because this is a planning paper, new knowledge is not suggested but rather ways in which present happenings serve as a basis for next developments in education and practice.

The theory of seepage in foundations for dams has been treated in numerous articles and publications. The purpose of this paper is not to discuss such theoretical considerations, but to present briefly a number of instances which the writers have encountered in their professional practice, where seepage had actually occurred in existing foundations for dams or has threatened to occur, and likewise to discuss the actual measures which were taken to prevent this seepage or to control it to such an extent that it did not endanger the safety of the dam structure.