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The total span of procedures necessary for care of the human eye and its associated structures is broad. Two professional groups, optometrists and ophthalmologists share in providing this total care. Each must hold a valid current license to practice his or her profession and the extent of prerogative and limitations is spelled out in practice acts recorded in the Florida Statutes. Optometrists must complete a minimum of 2 years of college level instruction in a community college or university before enrolling in professional school. The duration of professional school for optometrists is 4 years, including clinical experience, which leads to the degree of Doctor of Optometry (O.D.). Ophthalmologists are basically doctors of medicine or osteopathic medicine. Although most practicing optometrists use some assisting personnel, the potential or more extensive use of technically trained assistants has been little exploited to date. Firm data on which to establish an acceptable order of priority among the several health professions' educational programs do not exist at this time. Continuing, intensive planning will be necessary. (Author/PG)

The record of practice in general medicine and primary care by osteopathic physicians of the U.S. is outstanding. The number of D.O.'s in the U.S. totals about 14,000 of whom some 13,000 are estimated to be active. Over 2,600 D. O.'s hold a current practice license in Florida but only about one quarter of these are presently living in the state. Osteopathic physicians tend to cluster around osteopathic hospitals, of which there are 17 in the state. The separate status of osteopathic and allopathic physicians shows many signs of disappearing. The cost of educating an osteopathic physician is quite similar to that for the M.D. since educational requirements are hardly distinguishable. The actual costs will vary somewhat with location and availability of existing resources, physical and professional. One point of unresolved difference between the two medical organizations involves the length of preparation for general/family practice. M.D.'s need 3 years of post-degree residency for certification; D.O.'s now require only 1 year of post-degree training. A lapse of some 7 to 10 years must be expected between authorization of any new school and the beginning of practice by its first graduates. (Author/PG)

How will the health professionals in the Southern Regional Education Board (SREB) region handle increased demands for health care? This document describes one course of action illustrated by current efforts to increase the supply of health personnel by a shortened curriculum in professional schools. Usually these programs offer only about 3 months less coursework than traditional programs but, by foregoing summer vacations, students can graduate in 3 years. Maldistribution, or the fact that physicians and other health personnel tend to congregate in urbanized areas and to avoid rural ones, is also a major factor in the delivery of dental care. The problem in nursing is the attrition rate, one of the highest of all professions. Given the expense of educating health personnel, the future of American health care appears to lie not in increasing numbers, but in a change in the working patterns of health personnel, patterns related to patient care and to others of the health care team. Preventive, comprehensive care; expanded roles for nurses and utilization of auxiliary personnel; and a team approach to health care--all applied within community settings--spell the future of American health care delivery, and the foci of many Southern curricula presented in this report. (Author/PG)

Presented in this preliminary report is one of seven assessments conducted by a special task force of Project Clean Air, the Human Health Effects Task Force. The reports summarize assessments of the state of knowledge on various air pollution problems, particularly in California, and make tentative recommendations as to what the University of California can do through Project Clean Air to alleviate those problems. In this report biomedical effects of air pollution are evaluated from epidemiological evidence and from experimental studies. Human hazards are emphasized to establish whether enough evidence exists to set air quality standards because of demonstrated human health effects. Section I provides a review of the findings and suggests basic and applied research that is needed. Section II enumerates: (1) the biomedical effects of fossil fuel combustion, (2) effects of individual pollutants, (3) effects of inherited metabolic patterns on air pollutant susceptibility, and (4) environmental carcenogens, mutagens, and teratogens. The last section offers tasks recommended for the Project in the nature of mission-oriented programs. Literature cited is listed. A related document from the Automobile Engine Development Task Force is ED 052 938. (BL)

This document presents an outline of a program of instruction for a global medicine course offered in 3 blocks by the Department of the Army. The purpose of the first block, which would take 156 hours to complete, is to provide Army Medical Department officers with a basic working knowledge of, and the fundamental concepts underlying, biostatistics and epidemiology that will enable them to plan, conduct, and evaluate scientific investigations in the biomedical field. The second block, consisting of 220 hours, is to provide Army Medical Department officers with advanced training in diseases occuring in tropical and other areas of the world. The third and final block consists of 132 hours and has as its purpose training Army Medical Department officers in (1) environmental factors of medical and potential military importance; (2) the examination and evaluation of all disease problems using the ecological approach; and (3) the appropriate use of public health and preventive medicine principles in varying environmental and cultural situations. (HS)

Cable television offers a great potential for the improvement of present health services. A multipurpose cable communications system, adapted to interorganizational medical uses, could constitute the communications infrastructure needed in the present disorganized state of health care delivery. Such a system of video and data transmission offers better medical record keeping, faster medical testing and referral, opportunities for personnel training and continuing medical education for doctors in the community, and opportunities for much improved administrative communication. Ultimately costs would be less and efficiency far greater. Disadvantages to the incremental implementation of such a system are discussed, along with the examples of the use of cable television in medicine to date. (RB)

This catalog lists 27 audiovisual programs produced by the Department of Medical Communications of the University of Texas M. D. Anderson Hospital and Tumor Institute for public distribution. Video tapes, 16 mm. motion pictures and slide/audio series are presented dealing mostly with cancer and related subjects. The programs are intended for in-house hospital staff or other professional audiences. Each program is described and an abstract of the material given. Information for obtaining the audiovisual programs is included. (RB)

The need of the professions to update is studied. It is pointed out that the half-life in a professional's competence is the point in time after the completion of training when he had become roughly half as competent as he was upon graduation. Obsolescence is defined as a reduction of efficiencies of performance over time. It has been found to exist when there is a discrepancy between job needs and managerial or professional capabilities as a result of innovation. It is stated that the motivational process at the adult and professional level is a major undeveloped area and one which continuing education should explore. Various methods of assessing competence include: testing, questionnaires, interviews. Research in continuing education has been found to be light in both quantity and quality. Continuing education approaches are studied in the following fields: medicine, natural resources, education, psychology, law, biological science, dentistry, management, engineering. (Author/CK)

Articles on existing programs of adult education operating outside of institutional sponsorship are presented. The articles about adult education classes for Indians and teaching English as a second language report developments in programs that have only recently been established, while articles on the Junior League, adult activities in the community centers of Vancouver, and rural adult education inventory existing program areas that have not been reported previously. The second section contains articles about public school adult programs, the extension activities of the University of Victoria, and the community colleges of B. C. The final section of articles reviews adult education in the health sciences as it has emerged in continuing medical education and as it may be needed in rehabilitation medicine. A chronology of the early history of adult education until 1914 and a working bibliography about adult education in British Columbia are also included. (Author/CK)

Although there are social pressures for the control of science, forcing a redirection to "relevant" problem solving tasks, the future needs are, in essence, unpredictable in detail. For this reason fundamental research is necessary to provide the appropriate base for the new technologies that human society will need. Even to solve the present problems, fundamental research approaches are needed to provide the information base that can be used technologically to maintain the ecosystems in a satisfactory state. There are faults with the present mechanisms of supporting basic scientific research, and new mechanisms need to be developed for the effective utilization of Federal funds. In addition, the economic, social, moral and political implications of scientific research need to be considered as important, but not the only determinants of scientific policy. (AL)

In Part I of the Session, Network members describe and compare their experiences in utilizing various aspects of the SUNY Retrieval System including "query" cycle, scan statements, author searches, and book files. Machine problems are discussed as well as options on charging for searches, how much information to retrieve, and serving outside patrons. Suggestions for improvements are brought up including a more detailed search manual and the addition of tradings to the citations. Each library's unique use of the system based on its particular clientele and specific needs is brought out in this section. Part II focuses on the ability of users to successfully retrieve material from the data base in relation to such factors as machine capabilities, search strategy, suitability of search to system, and degree of training of search analysts. The need for identifying those aspects of an on-line information retrieval system which require establishment of particular policies and philosophies of service is made clear in these proceedings. (Author)

Highlights concerning the major policy issues affecting the distribution of health services in the United States are presented. Findings which support the view that the United States is attaining equilization of health care opportunity include: (1) The gap between the percentage of low and high income people seeing a physician during the year narrowed considerably between 1963 and 1970; (2) Once they see a physician, low income people average more visits than those of higher income; (3) The lowest income people are almost twice as likely to be admitted to a hospital as those with the highest incomes in 1970; and (4) Although non-whites and central city residents have longer lengths of stay once they are admitted to the hospital, their admission rates were still lower than for the rest of the population in 1970. It is concluded that while great improvements in health care for disadvantaged groups have occurred over the last 10 to 20 years, these groups are silll not equal to the remainder of the population. (Author/CK)

This study of chronic illness in the home originates in theoretical and practical questions posed by physicians, nurses, and biometricians. The study covers the following elements: The research plan, the patient sample, providing continued care, interviewing, classification of disease and mental status, effect of treatment program, classification of social factors, and interpretations. (7) Methods include statistical methods, evaluation schedule, and intake and outtake variables. (CK)

This study of medical education was conducted as a part of the Tennessee Higher Education Commission's responsibility to design a master plan for higher education in Tennessee. It provides a background of information on Tennessee's needs for physicians and on the production of physicians by the three medical schools in the state. The study examines the need for additional medical education at both undergraduate and graduate levels and analyzes the question of whether Tennessee needs another medical school. It is not concerned with details of curriculum, except as these may have an effect on the supply of physicians. Instead, it concentrates on the broader public policy question of providing necessary training programs. The study assumes that whatever changes and expansion takes place, the curricula and programs will be operated at a high level of quality. (Author)

A review is made of the literature on continuing education in the health professions. After an overview of the study, six chapters cover continuing education in medicine -- physical composition and distribution, participation in continuing education, organization and administration, instructional processes, evaluation, and summary and conclusions. Then follow four chapters on dentistry -- the profession and continuing education, participation, program administration and organization, and a summary. Four chapters on nursing discuss nurse composition and distribution and concern for continuing education, characteristics of the participants, sponsors and programs, administration of the programs, and some sample programs. Four chapters on continuing education in pharmacy are followed by major conclusions of the study. There are references at the end of each section. (Author)

This 1-day colloquium, attended by 23 participants representing societies, government agencies, colleges and universities, and other training programs, was conducted for the purpose of reporting on and discussing the curriculums developed at the University of Cincinnati for training nuclear medical technologists. Pilot programs at both the baccalaureate and associate degree levels have been established under a training grant from the Bureau of Radiological Health. Individuals going through the 2-year program are called Nuclear Medicine Technicians and those earning a baccalaureate degree are termed Nuclear Medicine Technologists. Twelve presentations were made and discussed, followed by four workshops devoted to preassigned questions involving such problems as (1) estimating the present and future needs for additional technologic personnel in nuclear medicine, (2) the content of the academic work in associate and baccalaureate programs, (3) methods of recruitment, and (4) future involvement of government agencies in sponsoring training programs. (GEB)

An On-Line Modeling System (OLMS) which should be particularly useful to the biomedical community is described which utilizes a process called "overlaying" to simplify loading and executing programs. OLMS has been constructed and implemented as an interpreter; that is, a program that translates and then executes each source statement in sequence where these two operations follow each other in close time proximity. It has been written so that it can be run under the IBM S/360 and the PDP-10 operating systems, but has been implemented only on the PDP-10. OLMS operates from a command language that is executed interpretively through a set of closed subroutines. The user may run a job, save data, get data, and display data. While his program is running, he can access the whole memory. This report consists of a description of OLMS and programmer's reference manuals for both the OLMS graphical system and OLMS. (JY)

The unique factor in the Medical Information Project is that working from ground zero, it undertook to design and put into operation a communication system for general medical practitioners using an individualized, programmed, audiovisual medium. The development of this system involved three general phases. Phase I, consisted of: (1) obtaining and reviewing literature pertaining to medical communication problems; (2) designing a means of sampling, drawing the sample, obtaining the physicians' participation; (3) laying out the general design for research and development; (4) developing and validating the instruments to be used to assess the physicians' cognitive and affective reactions; (5) testing and selecting the hardware to be used as the communication device; (6) developing the programming concepts; (7) developing the production process and (8) selecting the content areas and the medical consultants for the program topics. Phase II, consisted of (1) distributing the hardware to the participating physicians, (2) producing and distributing the training program on equipment utilization, (3) pre-and post-program questionnaires and interviews and (4) producing and distributing the fifteen content programs. Phase III consisted of: (1) collecting and processing raw data, (2) analyzing the data and (3) writing the final report. (Author/NH)

A program of education including training materials is presented to improve the technical proficiency of medical record clerks in small, rural hospitals. The program is planned for fifteen days of instruction or approximately 120 hours including evaluation, orientation and discussion sessions. Students are expected to have a high school diploma and no training beyond that received on the job. The material in the manual is organized in a unit plan to allow the instructor to fit the material to his teaching situation. (The student manual for the program is available as LI 003096.) (AB)

The manual provides major topics, objectives, activities and, procedures, references and materials, and assignments for the training program. The topics covered are hospital organization and community role, organization and management of a medical records department, international classification of diseases and operations, medical terminology, legal aspects, standards, education and training, and data processing. (The Instructor's Guide for the training program is available as LI 003097). (AB)

In terms of examples drawn from clinical and research data files, one of the objectives of this study is to illustrate several factors that have combined to delay the implementation of medical data bases. A primary factor has been inherent in the design of computer software. The languages currently on the market are procedural in nature: they demand the complete definition of a problem before a program can be run on the machine. This is a serious difficulty because medical information -- as opposed to mathematical quantities -- cannot be cast in a definite format, and questions of interest to a potential investigator cannot always be enumerated before the data is acquired. The constraints placed on data retrieval in the environment of a Blood Bank, for example, are such that on-line interaction with short response time is the basic design objective. In order to clarify the problems of interactive data handling in time-sharing under such constraints, a series of five experiments using the Direct Access Project (DIRAC) language prototype is explained. (Author/MM)

This second edition of the catalog, published in Spanish, contains information on programed materials and programed courses written in Spanish. The names and addresses of 30 publishing houses, private businesses, and governmental agencies are given in the source list. Over 130 programed courses and texts that are available from these sources in Mexico, Central and South America, and Spain are listed. Subjects covered by the courses include science, languages, medicine, mathematics, music, education, and business. When available, the length of time to complete the course, the number of frames or pages, and the intended instructional level are indicated, and for many, a brief synopsis is supplied. A number of Spanish source articles which contain information on programed instruction are listed, as well as the 19 papers which were presented at the First Argentine Congress on Programed Instruction held in Buenos Aires in July of 1970. (MT)

The subject of the content of medicinal chemical journals is briefly discussed as an aid for medicinal chemists who require information from clinical, health science, pharmaceutical science and chemical science areas to carry out their work. Some future changes in the present journal concept are considered. (Author/AB)

The report stresses the fact that while there is unity in the continuum of medicine, information in health care is markedly different from information in medical education and research. This difference is described as an anomaly in that it appears to deviate in excess of normal variation from needs common to research and education. In substance, the report states that information provided to researchers and educators can be anticipated to a large degree and that this lead time can be used to advantage by publishers, authors, and lecturers. In problems of medical care, the lead time is lacking and the information system must react to inquires after-the-fact. In essence what was good for education and research is not as effective in health care and collateral resources are called in to fill the void. This report calls for an upgrading of directories, compendia, and guides to enable physicians to locate and use information in a severly time-constrained problem environment. It implies that there should be some innovative re-grouping of all types and sources of information to allow the clinician to gain as much from a national network as do the researcher and educator. (Author)

The results of research work undertaken by the University of Pittsburg, and the Interuniversity Communications Council (EDUCOM), in behalf of the National Library of Medicine on the general subject of biomedical communications and information networks is summarized. The prinicpal purpose of the project is to explore the potential of the new communications technology for the distribution of medical information to physicians in support of their clinical, research, and educational interests. The research indicated that the world of medical information is a multi-dimensional problem. Medical information varies not only as a function of the physician's speciality, education, environment, and personal interests, but also as a function of his relationships with his patients and as a function of time. (Author/MM)

The purposes of this study are to identify and define viable remote browsing techniques and the requirements for an interactive medical information system that would permit the use of such techniques. The main emphasis is in the areas of: (1) remote viewing of page material; and (2) remote interrogation of fact banks with question-answering abilities. After considering a variety of alternatives, a remote-viewing design approach was found that appears to be feasible, economical, and eminently well-suited for integration into the Biomedical Communications Network. In the areas of question-answering systems the development of deductive and language-processing capabilities was carried forward in the direction needed to support the requirements of a drug-effects information system. A small data base was constructed, and the formal ability of the system to carry out language analysis and deductions on this base was demonstrated. (Author/NH)

The use of the computer for medical information processing was introduced about a decade ago. Considerable inroads have now been made toward its applications to problems in medicine. Present uses of the computer, both as a computational and noncomputational device include the following: automated search of patients' files; on-line clinical data processing; fetal heart rate and fetal electrocardiogram data acquisition; heart auscultation by computer; metabolism data acquisition; pattern recognition by computer; medical diagnosis using the logic of the propositional calculus; computer simulation of diagnostic problem solving; and computer-based medical instruction. (Author/JY)

This study attempted to examine dental manpower and variables related to it in Pennsylvania in the context of the national dental manpower. Findings include: (1) Optimum demand, based on dental care for all in the next decade, would require 2,495 additional dentists. (2) Women find a career in dentistry to be very satisfactory but only one-half percent of the dentists in the United States are women. (3) Changing to a 3-year instead of a 4-year dental school curriculum could produce 232 to 320 additional dentists in 1973-80 and meet more than half of the need for more dental manpower. (4) If the water supply were universally flouridated in Pennsylvania, the manpower need for dentists would be reduced, thus providing manpower for improved care. (5) Projected dental manpower needs for Pennsylvania for 1973-80 can be met without increasing dental school facilities by (a) enrolling more Pennsylvania students in Pennsylvania dental schools, thus reducing nonresident admissions, and (b) increasing the use of dental auxiliaries, particularly dental assistants. Related tables are included in the appendices. (Author/PG)

This report records the planning process of curriculum development for the projected undergraduate program of gerontology at the Institute of Gerontology, Federal City College. The goal of the project was to develop curriculum studies in aging for Federal City College undergraduate students, interested community persons, and workers employed in services to the elderly. The planning of the curriculum and general program of the Institute was required to: (1) relate directly to the needs of older persons in the Washington area; (2) identify and relate training to specific employment possibilities in services to the aging; (3) meet in-service training needs of direct service workers, owners, managers and supervisors of long-term care facilities; (4) present tentative training plans leading to A.A. and B.A. degrees with identified field placements; (5) develop possible short courses; and (6) locate potential faculty for teaching in the program. Three surveys were undertaken to gather information relevant to the planning of the curriculum: one on senior citizens, one for employees working with the aged, and one on agencies serving the aged. Perhaps as important as the surveys, the development of the curriculum has been influenced by the actualities of possible implementation. Appendices include the survey questionnaire, course offering schedule, community activities, and sample of student field reports. (Author/PG)

A course on South west history part of a high school career curriculum project, is outlined. Objectives for each part of the course are listed. Course titles include: Urban Problems in the Southwest, Mexican Americans in the Southwest, Southwest History, Americans in the Southwest, Indians in the Southwest, Urban Problems, and History of Business and Industry. Several course titles have more than one learning package, each outlined in a similar format consisting of a problem statement, objectives, required reading materials and activities, and extra reading materials and activities. Packages include: The Mexican-American Today; Mexican-Americans Begin to be Heard; Cowboys; Medicine; Business in the Southwest; Ancient Indian Culture; Pueblo, Hopi, and Zuni; Red Power; Apache Group and Comanches; Mining in Arizona; Introduction to Urban Problems; Race Relations in the Cities; Planning; Crime; and Western Justice. The units on American Indians contain reproductions of literature, songs, symbols, and Indian picture writing. Related documents are SO 006 460 and SO 006 461. (KSM)

The National Library of Medicine (NLM) has prepared a selected computer-generated bibliography from recent international journals on sudden death in infants. Each of 108 citations is accompanied by descriptors selected from the NLM's list of medical subject headings to facilitate the use of the retrieval system for those who are interested in doing more extensive research. (CS)

The design of codes and formats for information storage must be guided by the requirements of the processes in which the stored information is to be used. In the case of medical data, a code must be designed to facilitate several different processes, including case management, administration, evaluation and research. Design of such a system can be facilitated by an examination of the theory, in which knowledge is represented by a formal model consisting of nodes and arcs connecting the nodes. Arcs are of five types: paradigmatic, syntagmatic, discursive, attitudinal and metalingual. Metalingual arcs, which allow for shifts in level of abstraction, provide the only natural means of passage among the several languages of medicine. The technical problems raised by these shifts have been neglected in the philosophy of science, in linguistics and in information retrieval. Any cognitive network needs to record paradigmatic, syntagmatic, discursive and metalingual arcs; attitudinal arcs are also sometimes needed. Medical record files must be able to keep all types of linkages to provide accurate histories, and medical authority files need them to record the structure of the science. The SNOMed system provides some, but not all, of these linkages. (Author/SL)

This report documents the findings of a study into the information-seeking behavior of allied health personnel in a three county region in Ontario and also a survey of the resources and services which already exist to satisfy the information needs of these people. The study was undertaken for the purpose of gathering decision-making information prior to the establishment of a medical library network in Ontario. The medical network as envisioned by the Committee would fulfill three functions: (1) Allow a health worker to ask a single query to set the whole retrieval function into operation, (2) Integrate, where possible, special collections and services within the province into the system, and (3) Have, as central resource, federal health library services, which would provide access to MEDLARS and other international information resources. The constantly changing nature of health care patterns makes it imperative that good library service be available to all people involved, either directly or indirectly, in the care of patients. The proposed information network would aim to provide quick and effective service to all health personnel in the province of Ontario. The network would comprise three levels of responsibility: the primary contact library, the health resource library, and the central resource. (Author/SJ)

This document reports the procedures and data of a study designed to examine the hypotheses that medical practices do vary significantly. Detailed data on 76 participants were collected; three mechanisms were developed to determine the needs of primary care physicians. These mechanism were: subjective analysis by both participants and study staff, survey of participants and retesting of some participants to determine if their scores improved between the beginning and end of the study. Results indicated: (1) while there were similarities among individual physician's practices, they do vary substantially in terms of identifying individual educational needs, (2) it is possible to identify individual educational needs for medical specialists, (3) it is possible to identify individual educational needs for family-practitioners, (4) individual educational needs do vary, and (5) it is possible to design personal educational programs for physicians based on the health care they are called to deliver. (MJM)

This document is a lengthy summary of the Report of the National Study of Optometric Education. Contents include: introductory material; evolution of optometric training; vision care; institutions providing optometric education and their objectives; the scope of optometry; educational implications of contemporary developments in optometric practices; manpower in optometry; faculty, curricula and libraries of colleges of optometry; students of optometry; vision research and optometric education; and financing optometric education. Recommendations concern cooperation with other professions, manpower in optomery, curriculum in optometry, faculty in schools of optometry, students of optometry, and financing optometric education. (MJM)

The manual contains listings of health and hospital occupations, state and national health organizations, Missouri colleges and universities, Missouri licensing boards of health professions, and training programs for health occupations in Missouri. This last section, comprising 288 pages, covers health administration, public health, anesthesia, chiropractic, cytotechnology, dentistry, dental assisting, dental hygiene, dietetics, inhalation therapy, medicine, medical assisting and records, laboratory technology, nursing, occupational therapy, operating room technology, optometry, osteopathy, pharmacy, podiatry, practical nursing, prosthetics and orthotics, clinical psychology, radiologic technology, environmental sanitation, social work, speech and hearing, and veterinary medicine. Requirements for certification in the various fields are given. Information for specific programs, in Missouri and elsewhere, includes the name and address of the institution, duration of program, prerequisites, student capacity, tuition, financial assistance, degree or certificate granted, accreditation, and examining boards. There is no alphabetical index. (MS)

The Bio-Medical Library at the University of Minnesota has access to two on-line computer systems: the MEDLINE system (MEDLARS ON-LINE) of the National Library of Medicine and the State University of New York (SUNY) Biomedical Communication Network. MEDLINE consists of two files which provide coverage of the "Index Medicus" from 1970 to the present. The SUNY network offers the same on-line retrieval of "Index Medicus" but also includes off-line retrospective searches from 1964 to date. In addition, the SUNY system has a title scan feature which permits title searching by any specific terms desired to pinpoint information. The MEDLINE system is used unless the subject area of the search is peripheral to clinical medicine, a comprehensive search prior to 1970 is needed, or a very specific term is required. In these cases or when the MEDLINE system is not available, the SUNY system is used. (JG)