Citizen participation in neighborhood health centers for the poor: the politics of reform organizational change, 1965-77.

Through a longitudinal study of neighborhood health centers for the poor in the United States, this paper presents an analysis of the political economy of change within reform organizations. In the final accounting, we seek to explain the shift in the role of poor people participating in health care decision making from that of program developer and change agent to the role of program restrictor. We conceptualize the neighborhood health center (NHC) as a reform organization whose initial objective was to use health care as a tool for achieving political and economic development within low-income rural and urban communities. The analysis, based on a prospective study of NHCs between 1965 and 1977, using interviews with citizen board members, NHC project administrators, NHC physicians, HEW decision elites, and oral history interviews with former Office of Economic Opportunity (OEO) administrators and directors, exemplifies the generic social organizational problem of how social, political, economic, and ideological forces shape the emergence and performance of a new reform organization.

Rapid diagnosis of actinomycosis by thin-needle aspiration biopsy.

Actinomycosis was diagnosed in three cases by the use of thin-needle aspiration biopsy technic. Aspiration was utilized for morphologic studies and collection of material for microbiologic isolation. The critical histologic features of sulfur granules remain intact with aspiration technic. Thin-needle aspiration biopsy is a safe, simple, and rapid technic employed in the diagnosis of neoplastic disease. The use of this technic in the diagnosis of actinomycosis is demonstrated in this report.