New expectations for public housing.
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A nonviolent protest by prisoners began a 2-year planning process leading to the implementation of contractual medical services at Baltimore City Jail. This study was conducted in order to assess the impact of contractual services on the process of men's sick call. The contractual program was associated with a decrease in utilization of men's sick call: 62.9 patient visits per day per 1,000 prisoners in 1975 versus 27.4 patient visits per day per 1,000 prisoners in 1978; an increased duration of encounter; 2.8 minutes in 1975 versus 10.9 minutes in 1978; and with changes in prescribing patterns and in categories of patients' complaints. Baltimore City Jail spent about $588 per prisoner-year during fiscal year 1977, and about $670 per prisoner-year during fiscal year 1978, the first year of contractual services. We conclude that a system of health services for a large, urban jail can allow time for humane and professional encounters between providers and patients.
The University of Texas Health Science Center at Dallas, School of Allied Health Sciences, has designed and established a linkage plan that could help solve the health personnel shortages in many cities. This plan joins several schools to (1) stimulate the implementation of programs to provide limited numbers of trained health professionals, (2) establish a coordinated system whereby technologists and technicians can be trained, (3) prepare qualified persons to staff the local hospitals, and (4) provide a ladder for advancing motivated and qualified health professionals. Coordination of efforts among the university, the seven-member Dallas Community College District, and the Dallas Independent School District's High School for Health Professions facilitates solid academic instruction at these institutions, which is followed by well-supervised clinical experiences in the local hospitals under highly qualified professionals. To date, the program includes the education of nuclear medicine technologists, radiation therapy technologists, electroencephalographic technologists, and histologic technicians. This mode of education is one solution to the health professional shortage.
More than thousand years of mining and metallurgical engineering in the Harz mountains is the reason why heavy metal contamination in soil and air by arsenic, cadmium and lead is a problem in parts of the Harz region. Risk assessment is the duty of the district community physician. Checkup of sanitary conditions in habitat planning is very important and the basis for the development of healthy cities.
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