Lowering the cost of psychiatric care. An experimental brief-stay unit with the nurse as therapist

This paper reports a four-year experience and includes follow-up data from the operation of a novel inpatient general hospital unit. The two main features of the unit are: a relatively brief duration of hospitalization; and the employment of nursing staff as therapists in exactly the way residents are usually used.

The inpatient stay is considered to be a special opportunity for organizing important changes in the life styles and living arrangements of patients. It is also a time for making careful observations of behaviours and treatment trials. Daily interviews are conducted, including family members and other relevant persons.

The nurse-therapists are trained to perform individual and family therapy as well as to organize all the social and environmental contacts. They conduct groups and behaviour therapies and are in charge of the planning for discharge.

The patients here differ little from those in other general hospital units and the follow-up data show results to be at least as good as those reported anywhere else.

The shortened hospital stay represents a considerable saving, and the use of the nurse-therapist has important implications for economies in the health care system. There are some problems with the role changes required to make this system work but it is felt that the benefits far outweigh the disadvantages.

Blink coding for information display

Ten men scanned cathode-ray-tube displays to search for designated target items. Search time increased with increasing display density, and was 50% faster when a 3-cps blink was imposed on items of the target class. The blinking of nontarget items was almost equally effective, indicating that blink can be used either as an inclusion or exclusion code. In comparison with steady, nonblinking displays, search time was not significantly different for displays in which all items blinked, or in which a random selection of items blinked. It is concluded that for visual search tasks of the kind reported here, there is no marked deleterious effect of blink coding on symbol legibility, and no marked interference attributable to irrelevant blink.

Canadian doctors: victims of the abortion laws

Present Canadian abortion laws are victimizing the medical profession by insisting that doctors make moral decisions while society and the legislators opt out of their responsibility in this regard.The laws are so vague as to be uninterpretable, dealing with undefined concepts such as "endanger" and "health". The doctor-patient relationship is utterly devastated in a completely unprecedented manner by the setting up of "boards" to make decisions about patients they do not know. The whole procedure specified by law is extremely wasteful, chance-ridden and productive only of personal moral opinions translated into haphazard decisions.The conclusion is drawn that, no matter what personal views be held on the subject of abortion, the entire medical profession must protest vigorously to have the present legislation abolished and to have abortion removed from the criminal code. It is suggested that hospital therapeutic abortion boards should approve automatically the opinion of the patient's own doctor to give recognition to the fact that it is not possible for the present law to be interpreted on a logical basis, case by case. This will force society to face its responsibilities and the government to come into the open with its own position on abortion.

School refusal with anxiety: a review of sixty-three cases

A review of 63 cases of school refusal with anxiety seen at the Maudsley Hospital, London, England, indicates that the disorder has the following features:

1) peak incidence at age 11 or 12,

2) higher proportion of youngest children in the family,

3) presence of three separate syndromes seems indicated (with some intermixtures), namely,

a) separation anxiety in the younger patients and in those whose difficulties started at a young age,

b) school phobia in the older patients without previous episodes, and

c) depression or withdrawal in some adolescents,

4) excellent prognosis as far as return to school is concerned, although somewhat poorer for patients of age 13 or over.

Changing patterns in psychiatric emergencies

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User input mode and computer-aided instruction

An evaluation of on-line computer-aided instruction within a management information system compared typewriter and lightpen input modes as students learned to use the system. The following conclusions were supported: 1. Computer-aided instruction is feasible in a general-purpose management information system; 2. It is also feasible to demonstrate retention of learned material through computer-administered tests; 3. Professional typing skills are not necessary to use the typewriter input mode effectively, provided that the inputs required are short and direct; 4. In this particular setting there seemed to be evidence that the typewriter was a more effective input device than the lightpen during the instructional sequence, but this evidence is questionable in view of considerable individual differences among the students; 5. Regardless of performance, students responded favorably to their experience with computer-aided instruction.

Do large shared displays facilitate group effort?

Twelve four-man groups searched and counted visually displayed items. In one session, they used a large display shared in common by the group members; in another session, separate smaller displays were viewed individually. Information was presented under conditions of equal visual angle, so that these two display modes were logically equivalent. Performance was 15 percent faster with the large group display than with the small individual displays. There was no significant difference in error frequency. Some subjects preferred the large display, some the small. In a supplementary study, running individual subjects rather than groups, there were no differences in speed or accuracy between the display modes. This suggests that the difference in group performance time resulted from some facilitating effect of the shared display on the process of group interaction.