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SUMMARYTuberculin testing of 176 personnel in a Liverpool hospital showed a total incidence of 68 % negative reactors. This remarkably high percentage was similar for each of the various groups of workers tested. We did not find the Tine test to be a satisfactory method of screening for tuberculin sensitivity because 30% were doubtful reactors. In these, further tuberculin testing by the Mantoux reagent was always positive.

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.

Serological testing of hospital personnel by the indirect fluorescent antibody (IFA) technique was used to indicate the distribution of Lassa virus (LV) activity in Liberia. Determination of the places of origin of the staff members as well as the sites of the hospitals indicated that LV is active in throughout Liberia. Prevalences of IFA varied from 3·8% at the J. J. Dossen Hospital on the coast in the south-east to 22·3, 23·5 and 40·4% in Lofa County hospitals inland in the north-west. Rises in LV antibody prevalences, high prevalences and relatively high IFA titres in hospital personnel suggest the LV activity is particularly high in Lofa, Grand Cape Mount and Nimba Counties.

IN a bid to reduce the National Health Service (NHS) drug bill Dr. James Cameron, chairman of the Council of the British Medical Association, has joined forces with Mr. David Ennals, Secretary of S...

The role of the hospital biomedical engineer is described with reference to design and development of equipment and its maintenance, provision of a technical advisory service, and teaching.

Patient management teams are able to diagnose and begin to solve their own problems with the help of a self-instructional health team development (HTD) program. In this case, the focus is on those task-related issues which limit team effectiveness.

Spontaneous abortions in hospital sterilising staff were analysed using data from a postal questionnaire and a hospital discharge register. The study included all the sterilising staff employed in Finnish hospitals in 1980; the controls were nursing auxiliaries. Data from the questionnaire showed that the frequency of spontaneous abortions was 11.3% for the sterilising staff and 10.6% for the nursing auxiliaries. When the staff were concerned in sterilising procedures during their pregnancy the frequency was 16.7% compared with 5.6% for the non-exposed pregnancies. Adjustment for age, parity, decade of pregnancy, smoking habits, and intake of coffee and alcohol did not affect the differences. The increased frequency of spontaneous abortion correlated with exposure to ethylene oxide but not with exposure to glutaraldehyde or to formaldehyde. Analysis of spontaneous abortions from the hospital discharge register confirmed the findings. Thus the results from the two independent analyses suggest that exposure to ethylene oxide in hospitals may carry a risk of spontaneous abortion among sterilising staff.

Disparity in application procedures and acceptance dates for medical technology internships in Michigan led to confusion for students, advisors and hospital personnel. The key to solving the problem was to unify the colleges/universities and hospitals on these issues. This article describes the processes that led to unification and the development of a computerized system of matching medical technology students with available internships. This system has proven to be extremely successful and carries implications for expanded utilization in allied health fields other than medical technology.

The elements which are necessary for a co-ordinated system of quality control of intravenous additive services are reviewed. It is argued that, with the use of advanced equipment, such a system can be established, even for this type of very divergent preparations. Major emphasis is placed upon in-process control, where the use of computerized systems creates the opportunity for an integrated quality control system.

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.