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affiliation between a medical school and
a teaching hospital, and to set them
forth in a manner that will be helpful
to medical schools and hospitals in
strengthening their existing affiliations
and in developing new ones." The
authors accomplish this and much more.
Employing a wide variety of appropriate
methodologies, the research team describes the medical school teaching-hospital complex in its total environment,
making an objective assessment of the
changing orientation of the medical
school toward the general health care
system and the reciprocal impact of
institutions on each other.
The study deals with hard data including analyses of written agreements
between institutions and in-depth interviews in a sample of medical education
centers. Interview subjects included
deans, administrators of hospitals with
varying kinds of affiliations with medical schools, medical students, and
others. The result is a broad range of
perspectives of institutional roles which
will be of interest to medical educators, hospital administrators, and community health planners.
The study makes it eminently clear
that successful affiliation among institutions does not depend upon a well
drafted contract and cooperative dayto-day administration alone, but upon
shared goals defined in operational
terms. The report should serve as a
reference of continuing value to those
responsible for such relationships and
hopefully will influence their future
One element in the report which
merits special emphasis is the research
team's observation that to the traditional teaching hospital objectives-patient care, teaching, and researchthere should be added a fourth-community service. While "patient care"
has an individual focus, "community
service" indicates a responsiveness to
the total pattern of health services into
which the hospital and faculty define
themselves. The authors not only demonstrate that acceptance of this objective
is far from universal but point out the
barriers to its accomplishment emanating from present arrangements.
Among the topics treated are the relative independence of the hospital and
schools, methods for achieving community-wide coordination of medical education, the nature of staff obligations to
differing institutional goals, medical staff
and faculty appointment patterns, the
"teaching" patient, and medical student
relationships. The issues are clearly
identified and provided with cogent
references to recent research effectively
integrated with the authors' observations.
The study is to be recommended to
all those concerned with one of the most
vital and difficult relationships in medical care.
A Series of Monographs. New York, N. Y.:
Academic Press (II I Fifth Ave.), 1965. 236
pp. Price, $10.50.
This lucid text brings together the
varied factors applicable to thermal
death rate studies on food spoilage
microorganisms. Particularly helpful
is the clear, reliable pathway demonstrated through the previously ponderous mathematics of thermal death
time evaluation (TDT), so necessary for
food sterilization processes. The student
and the industrial technologist will find
both scientific background and practicality for their needs.
The book has two logical major sections, Thermobacteriology and Thermal
Process Evaluation. The former covers
the concepts of bacterial growth rates,
specific food spoilage organisms, bacteriological laboratory routines, culturing of sporulating organisms, thermal
destruction concepts, and measurement
VOL. 57, NO. 3. A.J.P.H.
of thermal resistance of bacteria. The
latter section is primarily mathematical,
covering the established symbols, terms,
or equations, the basic considerations of
lethality measurement, the several "general" methods, the extended mathematical methods, the conversion of heat
penetration data, and finally typical
process determination problems. The
final examples of problem-solving are
accompanied by the necessary factor
tables. Thus, the evaluation of thermal
food sterilization cycles is now realistically possible for anyone seriously attempting to establish heat lethality requirements for part of a process or for
a sealed container.
The over-all material and concepts
should be of basic interest to microbiologists in the related fields of drugs,
pharmaceuticals, or other endeavors
wherein heat is employed to stabilize
or preserve commercial products against
bacterial involvement. The typography
is clean and there is evidence of careful preparation. This book can be recommended both for reference and for
active application. JOHN M. SHARF
APPLICATION-By John T. Fodor and Gus
T. Dalis. Philadelphia, Pa.: Lea and Febiger
(600 Washington Square), 1966. 176 pp.
Price, $6.50.