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This study of staff attitudes toward patient-led units spanned a 15 month period. It was found that patient-led groups were viewed as a threat to the domain of some professional staff who believed that the “sick person” could find relief only when “treated by professionals.” These attitudes persisted despite substantial evidence that patient-led groups served as a strong force for motivating long-term patients to leave the hospital.

The authors suggest that an unselected group of addicts can be engaged in treatment and that a successful outpatient methadone detoxification program can be carried out in a general hospital psychiatric emergency clinic. However, it requires a structured program, interested and trained staff members who are available on a daily basis (including some paraprofessionals), and a responsible senior staff member who can run the program, set necessary limits, and provide support for the other staff members. Such a program must be seen as only the beginning of a long-term therapeutic effort for addicts and is clearly most successful with addicts who can be reached at an early stage in their addiction.

SUMMARY The exposure of operating-theatre personnel to vapours of halothane during routine anaesthetic work was studied. The concentrations of halothane in the atmosphere of an operating theatre and in expired air and blood from the personnel were determined by means of gas chromatography. Possible deleterious effects of repeated exposures are discussed. The need for reducing the amount of waste anaesthetic vapours in operating theatres is pointed out. ZUSAMMENFASSUNG Die Beeintrachtigung des Operationssaalpersonals durch Halothandampfe wahrend der Routine-Narkosearbeit wurde untersucht. Mittels der Gaschro-matographie wurden die Konzentrationen von Halothan in der Operations-saalatmosphare, in der Ausatmungsluft und in Blut des Personals bestimmt. Mogliche schadliche Wirkungen des wiederholten Ausgesetztseins werden diskutiert. Schliesslich wird auf die Notwendigkeit hingewiesen, den Uber-schuss von Narkosedampfen in den Operationssalen zu reduzieren.

The results obtained during the first three years of a pathogen-free isolation unit containing five beds have shown that this type of unit can reduce the risk of infection in patients treated with intensive chemotherapy or in those who have granulocytopenia from various causes. It is suggested that treatment of cancer which involves these risks should be carried out routinely in sterile isolation units, and that it is urgent to build many more and much larger units.

Psychiatric hospitals with unit systems differ in productivity, as measured by an increase in turnover rates and a decrease in long-term residents. A study of 39 VA hospitals revealed that the most productive had special placement programs, smaller treatment units, and competition between unit staff. The ten most productive hospitals also had more applied research, a higher percentage of patients on unclassified units, and a higher ratio of social workers to patients than did the ten least productive hospitals. Despite generally favorable staff reaction to the unit system and increased hospital productivity, there are signs that VA hospitals are moving toward more specialized treatment wards.

(1968). Central Service: Course set up to meet need for trained C.S. technicians. Hospital Topics: Vol. 46, No. 4, pp. 125-132.

The authors investigated the hospital policy of requiring nose, throat, and/or stool cultures on newborn nursery personnel. A questionnaire was sent to 99 hospitals in Michigan to determine how many required cultures, of whom they were required and the effect of cultures on infection rates. The study indicates that there is much variation in policy on cultures and that use of cultures apparently does not affect infection rates within the nursery. Policies governing treatment of a positive culture vary considerably and no pattern of action is emerging. These findings, and a review of government regulations, which neither require nor recommend cultures as a means of infection control, led the investigators to question the rationale for use of routine cultures.

Over 300 psychiatric inpatients and their residents responded to a questionnaire eliciting their views concerning the degree of benefit derived by patients from each of 20 aspects of the inpatient experience in a university hospital psychiatric service. Three major trends emerged

Dispersal of Staphylococcus aureus into the air is fairly common and is sometimes profuse among men, but is rare and very slight among young women. Shedding from the skin is increased by friction from clothes. The main site of shedding is the skin of the perineal area. Dispersal can be reduced by bacteria-proof underpants.

Organisation of an autonomous spinal unit as part of a national accident insurance organisation

S INCE 1964 the National Institute of Mental Health has provided grants to public mental hospitals to initiate or improve inservice training programs. Each hospital can receive up to $25,000 a year for three years, with provision for renewal. To date, grants have been awarded to 212 institutions; 90 others that are eligible have never applied for funds. At first the inservice training was directed toward improving the abilities of aides, attendants, and technicians. Some institutions had already established aide training, ranging from brief orientation to extensive courses of 240 hours or more that included both didactic and practical training. Hospitals with minimal training programs were encouraged to broaden their scope, and those with adequate basic courses were urged to provide advanced training and to explore new roles for aides.

Successful return to work after illness or injury often depends on an efficient exchange of information between doctor and employer. Rehabilitation officers with experience in industry have been employed by the Royal National Orthopaedic Hospital, Stanmore, for several years and have established their value in acting as direct links between hospital and industry.

The authors describe an outbreak of intragroup prejudice on an adolescent service. The disturbance is traced to patient anxiety over prejudice against the mentally ill, as exemplified in a national event, the withdrawal of Sen. Thomas Eagleton as a candidate for Vice-President. The role of social prejudice as a source of anxiety and disturbed behavior within a hospital setting is stressed.

THE prolonged strike in which the hospital porters and other ancillary staff were recently involved was an unhappy and uncharacteristic episode in the life of the hospitals, where a friendly spirit of co-operation is usually to be found among all grades of staff. Indeed, in the early phase of the dispute there were doctors and nurses as well as members of the public who had considerable sympathy for the underpaid hospital workers whose pay rise had been caught in the freeze, but their sympathy began to run out when sick patients had to be turned away from hospitals and as . . .

To overcome current problems in reporting large numbers of laboratory results in a coherent manner, this hospital has installed a PDP-12 computer system. This instrument is free-standing, dedicated only to laboratory use, and is a “turnkey” operation. All reports, including cumulative patient summaries, billing reports, worklists, specimen labels, venipuncture lists, etc., are obtained from the computer. Communication with the computer is in English-language conversational mode. In this article the computer system is described and evaluated. The work-flow is diagrammed and a new type of requisition is presented. Information is provided for selecting the size and characteristics of a computer system for a laboratory. The considerable difficulties inherent in the successful establishment of such a system and its costs in a laboratory are discussed.

Experience at the First Australian Field Hospital in South Vietnam showed that the procedures developed in that hospital for the reception and resuscitation of casualties were effective. Resuscitation was by infusion of Hartmann's solution, until crossmatched blood was available. Thereafter, blood and Hartmann's solution were used. Operation was undertaken when the patient's blood volume had been restored to normal. Examples are given of seven clinical cases. It is suggested that the experience gained can be applied in civilian life.

A Community Cancer Hospital in association with a General Hospital is a fruitful possibility in almost any city of moderate size and resources. This arrangement permits the utilization of various professional talents without prejudice to their private interests; it allows for cooperation and continued education of members of the staff; it can provide the necessary facilities, organization and skills for adequate diagnosis and treatment of cancer; it offers unique opportunities to train scarce tumor pathologists, cancer surgeons, therapeutic radiologists and oncologic chemotherapists; it provides the necessary atmosphere for clinical research. It is the true beginning of any Regional Medical Program which touches cancer.

The reliability of the Uricult dipslide in the quantitative estimation of bacteriuria has been tested on 2,596 urines from out-patients and in-patients of various types. The dipslide results at 15–20

SUMMARYThe spread of coagulase-positive staphylococci has been studied in a modern hospital in which most of the patients were nursed in 4-bed rooms separated from a common corridor only by low dividing walls. Acquisition of new nasal strains from patients in other bedrooms was nearly as easy as from patients in the neighbouring beds. There was no indication that subdivision of this type hindered the spread of nasal strains as compared with open wards of the ‘Nightingale’ pattern.

The intravenous infusion has become indispensable in modern medical therapy, but infection, especially infusion-associated septicemia, remains a life-threatening hazard. In 1970 to 1971 a ...

Summary Outbreaks of hepatitis have occurred in renal units all over Europe and the U.S.A. and have carried a high mortality. This is an iatrogenic disease, transmitted by blood from carriers of SH virus, uraemic patients often suffering subclinical attacks. The risks to the staff of these units are so high that they should not be asked to undertake this work if outbreaks cannot be controlled.