EDITORIALS
REFERENCES 1. Naeye RL: Causes of fetal and neonatal mortality by race in a selected U.S. population. Am J Public Health, 69:857-861, 1979 2. Eisner V, Brazie JV: The risk of low birthweight. Am J Public Health, 69:887-893, 1979 3. Williams RL, Hawes WE: Cesarean section, fetal monitoring, and perinatal mortality in California. Am J Public Health, 69:864870, 1979.
4. Banta HD, Thacker SB: Costs and Benefits of Electronic Fetal Monitoring: A Review of the Literature. NCHSR Research Report Series, April 1979. 5. Banta HD, Thacker SB: Policies toward medical technology: the case of electronic fetal monitoring. Am J Public Health 69:931935, 1979. 6. Mosteller F, Tukey JW: Data Analysis and Regression: A Second Course in Statistics, Addison-Wesley Publishing Co., Reading, MA, 1977.
Infant Mortality and Morbidity In the International Year of the Child Seventy years ago Sir Arthur Newsholme coined the maxim: "Infant mortality is the most sensitive measure we possess of social welfare and sanitary administration, especially among urban conditions."' In England in 1909, 120 out of every 1,000 infants born alive died before attaining their first birthday. Similar conditions prevailed then in virtually all countries we now label as developed, industrialized or rich-for want of a better word. Similar conditions prevail now in virtually all the countries we label as belonging to the Third World-for want of a better word. Infant mortality today in the affluent nations of the world is approaching or has already passed the point where it is about one-tenth of what it was 70 years ago. One wonders whether Sir Arthur would think that social welfare and sanitary administration (public health services) in these nations are ten times better now than they had been in his day, or ten times better today than they are in the Third World. Social welfare is a value-laden term. If defined in the narrow sense of technological development, which is not the way Sir Arthur would have defined it, perhaps the one to ten ratio is not unreasonable. If defined in broader terms of society's ability to provide an environment for the optimum growth and development of its children,2 the proportion of infants who survive to the age of one year can hardly be called a satisfactory measure. Correlations between sanitary administration and infant mortality can probably be demonstrated, but do not fully explain the extraordinary fall in these rates during the past 70 years and their extraordinary contrasts by country in the present International Year of the Child. Nevertheless, perhaps because we have no more convenient statistical crutch on which to lean, infant mortality continues to play a symbolic role in the international rating game. The publication in this issue of the Journal of a number of papers dealing with infant mortality and morbidity allows us to ponder some of the paradoxes and problems that plague us. In the United States, in the 1950s, after two decades of rather rapid decline, the infant mortality rate started to level off but, in 1957, actually rose slightly.3 For the next ten years, the rate in Whites declined very slightly while for Blacks it either rose or was static. At the same time, the rates of peer countries continued to decline, and the United States slipped downward in the international rankings. Selfcastigation and a search for cause ensued.4 852
One hears less now about these international comparisons, and the shameful standing of the United States among its peers. After a decade of dawdling, the U.S. infant mortality rate again began to fall, reaching an estimated 14/ 1,000 in 1977,5 a figure about one-half that of the rate during the leveling off years. Although we are still no higher up in the international comparisons (at least four countries will probably produce single digit figures in 19776), our improvement parallels that of our peers. The risk ratio of Black to White babies has returned to what it was before the leveling off began: two to one. Many reasons for the eccentric behavior of the American infant mortality rate have been advanced by advocates of different causes and programs. Most likely there are a host of very different reasons, all of which played some unspecified part in the stop and start of the decline. Concern about the static position of the U.S. infant mortality rate in the late 1950s was one of the reasons which led to the massive undertaking known as the Collaborative Perinatal Project. From 1959 through 1966, the project collected detailed prospective clinical, pathological, laboratory, and psychosocial data on nearly 60,000 pregnancies and their outcomes. For a number of years now, Dr. Richard Naeye has been painstakingly culling these data tapes and scanning the microscopic slides to produce a series of unique reports on the early outcomes of these pregnancies. His reports are unique because it is unlikely that the money to finance so gigantic an operation will be available again in the foreseeable future. The nearest things to it (the British perinatal study7 and the PAHO childhood mortality study8) are retrospective. The Collaborative Study reports are unique also because they integrate detailed data-collected and classified in a standardized way for clinical, laboratory and autopsy sources-with the demographic and socioeconomic "indicator" data more familiar to epidemiologists. In the current issue of the Journal, Dr. Naeye delineates the specific causes of perinatal death for various racial groups within the selected Collaborative Study cohort and shows that the perinatal mortality rate for Blacks was some 47 percent higher than that for Whites.9 During these same years, the U.S. Black postneonatal mortality rate (traditional indicator of environmental influences) was three times as high as the White, and Dr. Naeye provides evidence-as if we needed it-that, within the selected study group, environmental rather than genetic factors account for the rather AJPH September 1979, Vol. 69, No. 9
EDITORIALS
substantial differences in perinatal mortality as well. Two other papers in this issue illustrate the application of statistical technology, far more sophisticated than that available to Sir Arthur Newsholme, to current issues surrounding infant mortality, low birthweight'° and fetal monitoring." In the analysis of data from California birth and death certificates, Williams and Hawes profess to find an indication that cesearean section and fetal monitoring have had a favorable effect on perinatal mortality." This conclusion is challenged, for different reasons, by two other papers in the current issue of the Journal.'2' 13 Whether or not the conclusion of Williams and Hawes12 is justified, it seems clear from the California study data that the minority groups who could be expected to benefit most from electronic fetal monitoring had least access to it. It is also clear, from the information provided by Banta and Thacker,'3 that our public health (sanitary administration) mechanisms to evaluate and control this costly new technology leave much to be desired. If the technology is beneficial, it benefits the California rich more than the California poor. One of the many reasons advanced for the striking decline in infant mortality during the twentieth century is improved nutrition. There is no doubt but what nutrition plays a major role in sustaining the current infant mortality contrast between the rich and the Third World. In another paper published in this issue of the Journal, Duncan and his colleagues provide information suggesting that the growth of Denver children (a reflection of nutritional status) demonstrates socioeconomic rather than genetic factors. 14 One of the reasons advanced for the downswing in U.S. infant mortality in the late 1960s is the widespread diffusion of family planning methods which occurred concurrently. This change in public attitude and spread of service programs culminated with the 1972 U.S. Supreme Court decision to legalize abortion. In 1977, however, when the Court ruled that federal funds for abortion for the poor were not guaranteed by the Constitution, these funds were withdrawn-leaving each state to cope with the situation as it saw fit. The dire consequences predicted as a result of this shift have not materialized. As three short pieces in the current issue of the Journal illustrate,'5-'7 state and private funds have filled the gap left by the withdrawal of federal funds. Given the present state of the economy, however, there is no assurance that inequity of access to abortion services, which already exists in a few states, will not become more widespread. In Sir Arthur Newsholme's day, the postneonatal component of infant mortality was substantially higher than the neonatal component, and mortality among the 1-4 year olds was as high as infant mortality today (this is still the case in the Third World). The need to tackle these problems led to the growth of well-baby clinics and health education programs early in the present century. The effects of these public health programs were never adequately evaluated apart from the immunization benefits they later incorporated. Today, although the postneonatal component of our infant mortality rate is less than one-half that of its neonatal component, the remnants of these programs are still with us, justifying their continued existence in ways that are illustrated AJPH September 1979, Vol. 69, No. 9
by two other articles in this issue. We turn our sophisticated technology to the identification of colors and symbols that will teach young children to avoid the poisonous substances the technology has created and diffused in our households;18 and we use it-in middle class families, no less-to promote more interaction between mothers and babies;'9 something, that in Sir Arthur's day, may have been taken for granted. There is little question that many new technologies have been developed and applied and that infant mortality rates have fallen dramatically during the past 70 years. Whether or not social welfare and sanitary administration or public health services have advanced to the same degree is less certain. For those who would view the state of children on the international scene, the April 1979 issue of the World Health Chronicle is recommended reading.20 For those who would look at our domestic situation, the collection of papers in the current issue of the Journal provides a partial and incomplete view. In either case, it is clear that we still have a long way to go in this 1979 International Year of the Child.
ALFRED YANKAUER, MD, MPH Dr. Yankauer is Professor of Community and Family Medicine,
University of Massachusetts Medical School, Worcester, MA, and Editor of this Journal.
REFERENCES
1. Newsholme A: Report by the medical officer on infant and child mortality. Supplement to the 30th annual report of the Local Government Board, London, 1910. 2. Schaefer ES: Professional paradigms in child and family health programs (editorial). Am J Public Health 69:849-850, 1979. 3. Infant Mortality Trends, United States and Each State, 19301964. National Center for Health Statistics, Vital and Health Statistics, USPHS Publication No. 1000, Series 20, No. 1, Washington, DC, 1965. 4. Moriyama IM: Recent change in infant mortality trend. Pub Health Reports, 75:391-405, 1960. 5. Monthly Vital Statistics Report, Provisional Statistics, Annual Summary for the United States, 1977. National Center for Health Statistics, DHEW Publication No. (PHS) 79-1120, Vol. 26, No. 13, Dec. 7, 1978. 6. Statistical Papers: Population and Vital Statistics Reports, Series A, Vol. 30, No. 3, United Nations, NY, 1978. 7. Butler NR, Bonham DG: Perinatal Mortality. London: E & S Livinston, 1963. 8. Puffer RR, Serrano CV: Patterns of Mortality in Childhood. PAHO Scientific Publication No. 232, Washington, DC, Pan American Health Organization, 1973. 9. Naeye RL: Causes of fetal and neonatal mortality by race in a selected U.S. population. Am J Public Health, 69:857-861, 1979. 10. Eisner V, Brazie JV, Pratt MW, Hexter AC: The risk of low birth weight. Am J Public Health 69:887-893, 1979. 11. Williams RL, Hawes WE: Cesarean section, fetal monitoring and perinatal mortality in California. Am J Public Health 69:864-870, 1979. 12. Thompson D: On getting the most out of multivariate data analyses (editorial). Am J Public Health 69:851-852, 1979. 13. Banta HD, Thacker SB: Policies toward medical technology: the case of electronic fetal monitoring. Am J Public Health, 69:931-935, 1979. 14. Duncan B, Smith AN, Briese FW: A comparison of growth: Spanish-surnamed with non-Spanish-surnamed children. Am J Public Health 69:903-907, 1979.
853
EDITORIALS 15. Cates W Jr, Kimball AM, Gold J, et al: The health impact of restricting public funds for abortion, October 10, 1977-June 10, 1978. Am J Public Health, 69:945-947, 1979. 16. Rubin GL, Gold J, Cates W Jr: Response of low-income women and abortion facilities to restriction of public funds for abortion: a study of a large metropolitan area. Am J Public Health 69:948950, 1979. 17. Gold J, Cates W Jr: Restriction of federal funds for abortion: 17
months later. (Commentary) Am J Public Health 69:929-930, 1979. 18. Braden BT, Gill N: Validation of a poison prevention program. Am J Public Health 69:942-944, 1979. 19. Chamberlin RW, Szumowski EK, Zastowny TR: Pediatricians' efforts to educate mothers about child behavior and development: relationships to measures of mother and child functioning over time. Am J Public Health, 69:875-886. 1979. 20. World Health Chronicle. Vol. 33, April, 1979. WHO, Geneva.
AAMI Call for Papers for 1980 Meeting The Association for the Advancement of Medical Instrumentation (AAMI) has issued a call for papers for its 1980 meeting, to be held April 13-17, 1980, Hyatt Embarcadero, San Francisco. This 15th Annual Meeting has as its theme "The Quality/Cost Dilemma in Health Care." The deadline for receipt of submitted abstracts is October 15, 1979. The final deadline for receipt of invited short papers is January 14, 1980. The AAMI annual meeting will address the specific points of careful planning in the use, application and integration of technology into the health care system, and judicious management of instrumentation, devices and systems. Participation in the meeting may take any of the following forms: * Individual presentation of information on a new development, relevant research or medical care
breakthrough; * Presentation of material on innovative systems approaches to management and practical applications with a hospital, laboratory, government agency, or other health care environment; * Direction of or participation in roundtable discussions on topical subjects of interest, with the objective of promoting communication and interaction among meeting registrants and to provide an informal forum for problem solving and exchange. Two awards will be presented for annual meeting papers of outstanding merit: The Student Manuscript Award includes a $150 prize, a,nnual meeting transportation and accommodations, and a recognition plaque for the best student paper in clinical engineering. The Annual Meeting Manuscript Award includes a $350 prize and recognition plaque to the author of the best manuscript reporting on a major contribution through medical instrumentation to patient care. Submit three copies of the full paper to AAMI, designating which award submission is for, by February 15, 1980. Interested persons may request the following from AAMI, 1901 N. Ft. Meyer Dr., Suite 602, Arlington, VA 22209, phone 703/525-4890: author kit; preliminary program; information on exhibiting; awards information; membership information; developing and chairing a session; roundtable discussions; and short course development.
854
AJPH September 1979, Vol. 69, No. 9
REFERENCES 1. Naeye RL: Causes of fetal and neonatal mortality by race in a selected U.S. population. Am J Public Health, 69:857-861, 1979 2. Eisner V, Brazie JV: The risk of low birthweight. Am J Public Health, 69:887-893, 1979 3. Williams RL, Hawes WE: Cesarean section, fetal monitoring, and perinatal mortality in California. Am J Public Health, 69:864870, 1979.
4. Banta HD, Thacker SB: Costs and Benefits of Electronic Fetal Monitoring: A Review of the Literature. NCHSR Research Report Series, April 1979. 5. Banta HD, Thacker SB: Policies toward medical technology: the case of electronic fetal monitoring. Am J Public Health 69:931935, 1979. 6. Mosteller F, Tukey JW: Data Analysis and Regression: A Second Course in Statistics, Addison-Wesley Publishing Co., Reading, MA, 1977.
Infant Mortality and Morbidity In the International Year of the Child Seventy years ago Sir Arthur Newsholme coined the maxim: "Infant mortality is the most sensitive measure we possess of social welfare and sanitary administration, especially among urban conditions."' In England in 1909, 120 out of every 1,000 infants born alive died before attaining their first birthday. Similar conditions prevailed then in virtually all countries we now label as developed, industrialized or rich-for want of a better word. Similar conditions prevail now in virtually all the countries we label as belonging to the Third World-for want of a better word. Infant mortality today in the affluent nations of the world is approaching or has already passed the point where it is about one-tenth of what it was 70 years ago. One wonders whether Sir Arthur would think that social welfare and sanitary administration (public health services) in these nations are ten times better now than they had been in his day, or ten times better today than they are in the Third World. Social welfare is a value-laden term. If defined in the narrow sense of technological development, which is not the way Sir Arthur would have defined it, perhaps the one to ten ratio is not unreasonable. If defined in broader terms of society's ability to provide an environment for the optimum growth and development of its children,2 the proportion of infants who survive to the age of one year can hardly be called a satisfactory measure. Correlations between sanitary administration and infant mortality can probably be demonstrated, but do not fully explain the extraordinary fall in these rates during the past 70 years and their extraordinary contrasts by country in the present International Year of the Child. Nevertheless, perhaps because we have no more convenient statistical crutch on which to lean, infant mortality continues to play a symbolic role in the international rating game. The publication in this issue of the Journal of a number of papers dealing with infant mortality and morbidity allows us to ponder some of the paradoxes and problems that plague us. In the United States, in the 1950s, after two decades of rather rapid decline, the infant mortality rate started to level off but, in 1957, actually rose slightly.3 For the next ten years, the rate in Whites declined very slightly while for Blacks it either rose or was static. At the same time, the rates of peer countries continued to decline, and the United States slipped downward in the international rankings. Selfcastigation and a search for cause ensued.4 852
One hears less now about these international comparisons, and the shameful standing of the United States among its peers. After a decade of dawdling, the U.S. infant mortality rate again began to fall, reaching an estimated 14/ 1,000 in 1977,5 a figure about one-half that of the rate during the leveling off years. Although we are still no higher up in the international comparisons (at least four countries will probably produce single digit figures in 19776), our improvement parallels that of our peers. The risk ratio of Black to White babies has returned to what it was before the leveling off began: two to one. Many reasons for the eccentric behavior of the American infant mortality rate have been advanced by advocates of different causes and programs. Most likely there are a host of very different reasons, all of which played some unspecified part in the stop and start of the decline. Concern about the static position of the U.S. infant mortality rate in the late 1950s was one of the reasons which led to the massive undertaking known as the Collaborative Perinatal Project. From 1959 through 1966, the project collected detailed prospective clinical, pathological, laboratory, and psychosocial data on nearly 60,000 pregnancies and their outcomes. For a number of years now, Dr. Richard Naeye has been painstakingly culling these data tapes and scanning the microscopic slides to produce a series of unique reports on the early outcomes of these pregnancies. His reports are unique because it is unlikely that the money to finance so gigantic an operation will be available again in the foreseeable future. The nearest things to it (the British perinatal study7 and the PAHO childhood mortality study8) are retrospective. The Collaborative Study reports are unique also because they integrate detailed data-collected and classified in a standardized way for clinical, laboratory and autopsy sources-with the demographic and socioeconomic "indicator" data more familiar to epidemiologists. In the current issue of the Journal, Dr. Naeye delineates the specific causes of perinatal death for various racial groups within the selected Collaborative Study cohort and shows that the perinatal mortality rate for Blacks was some 47 percent higher than that for Whites.9 During these same years, the U.S. Black postneonatal mortality rate (traditional indicator of environmental influences) was three times as high as the White, and Dr. Naeye provides evidence-as if we needed it-that, within the selected study group, environmental rather than genetic factors account for the rather AJPH September 1979, Vol. 69, No. 9
EDITORIALS
substantial differences in perinatal mortality as well. Two other papers in this issue illustrate the application of statistical technology, far more sophisticated than that available to Sir Arthur Newsholme, to current issues surrounding infant mortality, low birthweight'° and fetal monitoring." In the analysis of data from California birth and death certificates, Williams and Hawes profess to find an indication that cesearean section and fetal monitoring have had a favorable effect on perinatal mortality." This conclusion is challenged, for different reasons, by two other papers in the current issue of the Journal.'2' 13 Whether or not the conclusion of Williams and Hawes12 is justified, it seems clear from the California study data that the minority groups who could be expected to benefit most from electronic fetal monitoring had least access to it. It is also clear, from the information provided by Banta and Thacker,'3 that our public health (sanitary administration) mechanisms to evaluate and control this costly new technology leave much to be desired. If the technology is beneficial, it benefits the California rich more than the California poor. One of the many reasons advanced for the striking decline in infant mortality during the twentieth century is improved nutrition. There is no doubt but what nutrition plays a major role in sustaining the current infant mortality contrast between the rich and the Third World. In another paper published in this issue of the Journal, Duncan and his colleagues provide information suggesting that the growth of Denver children (a reflection of nutritional status) demonstrates socioeconomic rather than genetic factors. 14 One of the reasons advanced for the downswing in U.S. infant mortality in the late 1960s is the widespread diffusion of family planning methods which occurred concurrently. This change in public attitude and spread of service programs culminated with the 1972 U.S. Supreme Court decision to legalize abortion. In 1977, however, when the Court ruled that federal funds for abortion for the poor were not guaranteed by the Constitution, these funds were withdrawn-leaving each state to cope with the situation as it saw fit. The dire consequences predicted as a result of this shift have not materialized. As three short pieces in the current issue of the Journal illustrate,'5-'7 state and private funds have filled the gap left by the withdrawal of federal funds. Given the present state of the economy, however, there is no assurance that inequity of access to abortion services, which already exists in a few states, will not become more widespread. In Sir Arthur Newsholme's day, the postneonatal component of infant mortality was substantially higher than the neonatal component, and mortality among the 1-4 year olds was as high as infant mortality today (this is still the case in the Third World). The need to tackle these problems led to the growth of well-baby clinics and health education programs early in the present century. The effects of these public health programs were never adequately evaluated apart from the immunization benefits they later incorporated. Today, although the postneonatal component of our infant mortality rate is less than one-half that of its neonatal component, the remnants of these programs are still with us, justifying their continued existence in ways that are illustrated AJPH September 1979, Vol. 69, No. 9
by two other articles in this issue. We turn our sophisticated technology to the identification of colors and symbols that will teach young children to avoid the poisonous substances the technology has created and diffused in our households;18 and we use it-in middle class families, no less-to promote more interaction between mothers and babies;'9 something, that in Sir Arthur's day, may have been taken for granted. There is little question that many new technologies have been developed and applied and that infant mortality rates have fallen dramatically during the past 70 years. Whether or not social welfare and sanitary administration or public health services have advanced to the same degree is less certain. For those who would view the state of children on the international scene, the April 1979 issue of the World Health Chronicle is recommended reading.20 For those who would look at our domestic situation, the collection of papers in the current issue of the Journal provides a partial and incomplete view. In either case, it is clear that we still have a long way to go in this 1979 International Year of the Child.
ALFRED YANKAUER, MD, MPH Dr. Yankauer is Professor of Community and Family Medicine,
University of Massachusetts Medical School, Worcester, MA, and Editor of this Journal.
REFERENCES
1. Newsholme A: Report by the medical officer on infant and child mortality. Supplement to the 30th annual report of the Local Government Board, London, 1910. 2. Schaefer ES: Professional paradigms in child and family health programs (editorial). Am J Public Health 69:849-850, 1979. 3. Infant Mortality Trends, United States and Each State, 19301964. National Center for Health Statistics, Vital and Health Statistics, USPHS Publication No. 1000, Series 20, No. 1, Washington, DC, 1965. 4. Moriyama IM: Recent change in infant mortality trend. Pub Health Reports, 75:391-405, 1960. 5. Monthly Vital Statistics Report, Provisional Statistics, Annual Summary for the United States, 1977. National Center for Health Statistics, DHEW Publication No. (PHS) 79-1120, Vol. 26, No. 13, Dec. 7, 1978. 6. Statistical Papers: Population and Vital Statistics Reports, Series A, Vol. 30, No. 3, United Nations, NY, 1978. 7. Butler NR, Bonham DG: Perinatal Mortality. London: E & S Livinston, 1963. 8. Puffer RR, Serrano CV: Patterns of Mortality in Childhood. PAHO Scientific Publication No. 232, Washington, DC, Pan American Health Organization, 1973. 9. Naeye RL: Causes of fetal and neonatal mortality by race in a selected U.S. population. Am J Public Health, 69:857-861, 1979. 10. Eisner V, Brazie JV, Pratt MW, Hexter AC: The risk of low birth weight. Am J Public Health 69:887-893, 1979. 11. Williams RL, Hawes WE: Cesarean section, fetal monitoring and perinatal mortality in California. Am J Public Health 69:864-870, 1979. 12. Thompson D: On getting the most out of multivariate data analyses (editorial). Am J Public Health 69:851-852, 1979. 13. Banta HD, Thacker SB: Policies toward medical technology: the case of electronic fetal monitoring. Am J Public Health, 69:931-935, 1979. 14. Duncan B, Smith AN, Briese FW: A comparison of growth: Spanish-surnamed with non-Spanish-surnamed children. Am J Public Health 69:903-907, 1979.
853
EDITORIALS 15. Cates W Jr, Kimball AM, Gold J, et al: The health impact of restricting public funds for abortion, October 10, 1977-June 10, 1978. Am J Public Health, 69:945-947, 1979. 16. Rubin GL, Gold J, Cates W Jr: Response of low-income women and abortion facilities to restriction of public funds for abortion: a study of a large metropolitan area. Am J Public Health 69:948950, 1979. 17. Gold J, Cates W Jr: Restriction of federal funds for abortion: 17
months later. (Commentary) Am J Public Health 69:929-930, 1979. 18. Braden BT, Gill N: Validation of a poison prevention program. Am J Public Health 69:942-944, 1979. 19. Chamberlin RW, Szumowski EK, Zastowny TR: Pediatricians' efforts to educate mothers about child behavior and development: relationships to measures of mother and child functioning over time. Am J Public Health, 69:875-886. 1979. 20. World Health Chronicle. Vol. 33, April, 1979. WHO, Geneva.
AAMI Call for Papers for 1980 Meeting The Association for the Advancement of Medical Instrumentation (AAMI) has issued a call for papers for its 1980 meeting, to be held April 13-17, 1980, Hyatt Embarcadero, San Francisco. This 15th Annual Meeting has as its theme "The Quality/Cost Dilemma in Health Care." The deadline for receipt of submitted abstracts is October 15, 1979. The final deadline for receipt of invited short papers is January 14, 1980. The AAMI annual meeting will address the specific points of careful planning in the use, application and integration of technology into the health care system, and judicious management of instrumentation, devices and systems. Participation in the meeting may take any of the following forms: * Individual presentation of information on a new development, relevant research or medical care
breakthrough; * Presentation of material on innovative systems approaches to management and practical applications with a hospital, laboratory, government agency, or other health care environment; * Direction of or participation in roundtable discussions on topical subjects of interest, with the objective of promoting communication and interaction among meeting registrants and to provide an informal forum for problem solving and exchange. Two awards will be presented for annual meeting papers of outstanding merit: The Student Manuscript Award includes a $150 prize, a,nnual meeting transportation and accommodations, and a recognition plaque for the best student paper in clinical engineering. The Annual Meeting Manuscript Award includes a $350 prize and recognition plaque to the author of the best manuscript reporting on a major contribution through medical instrumentation to patient care. Submit three copies of the full paper to AAMI, designating which award submission is for, by February 15, 1980. Interested persons may request the following from AAMI, 1901 N. Ft. Meyer Dr., Suite 602, Arlington, VA 22209, phone 703/525-4890: author kit; preliminary program; information on exhibiting; awards information; membership information; developing and chairing a session; roundtable discussions; and short course development.
854
AJPH September 1979, Vol. 69, No. 9
