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Influential recommendations have been made that preparation for expanded roles in primary health care be part of basic nursing education. Much of the learning required for the roles is already included in many, if not all, baccalaureate programs. Implementation of these recommendations implies that short "add-on" courses such as the one described here should be considered interim measures to upgrade skills and knowledge of present graduate nurses, both diploma and baccalaureate. For such measures, continuing education should be available in a variety of courses which could meet in a flexible manner the varying needs and objectives of diverse service settings. As the expectations of consumers and service settings change, and as roles and functions evolve, variations and modifications in course offerings can then continue. It would be expected that, with clearer perception of the role to be ascribed to nursing in primary health care, such course offerings could be based soundly on data derived from systematic study of the effect of nursing. It is anticipated that the experience and findings of this project may have a contribution to make to the development of future courses. The project showed encouraging results from a working collaboration of a variety of health care personnel in both instruction and evaluation, and demonstrated that such courses can involve a variety of students from a variety of relevant practice settings. It is also felt that the evaluation approaches and tools evolved hold promise, with further refinement, of contributing to the development of evaluative procedures.

Optometrists, like all health care providers, should emphasize primary or preventive care. To provide this care optometrists must be aware of the risk factors for major causes of mortality. As an example, the risk profile for a white male age 45 to 49 years is given and discussed. Suggestions for primary vision care and detection of major risk factors by optometrists are also presented.

An attempt has been made to determine the true cost of providing primary health care for nontraumatic conditions in the emergency departments of two hospitals in Ontario and in the offices of family physicians. A total of 1117 patients presenting with 1 of 10 common symptom/sign complexes at the emergency departments or the offices of 15 participating family physicians were studies with regard to number of visits made, type of assessment by the physician, investigations undertaken, management, therapy and outcome of the illness. Costs were calculated from the charges that would be made against the provincial health services insurance plan and from the system of hospital financing in effect in the province. The average true cost per illness episode of this type of care was $14.63 in hospital A, $14.20 in hospital B and $15.90 in the family physician's office.