The National Patient Library. Evidence-based information for consumers.

A National Patient Library, a public/private partnership, is proposed to identify and vet information for consumers. Library staff will help tailor general information to consumers' specific needs. The library includes an electronic network. The principal focus of the library's information is controversial and experimental procedures, pharmaceuticals, and medical devices.

Is there an alternative to a National Health Board for Technology Assessment?

The National Health Board, a lynchpin of the managed competition philosophy of health reform, would perform a necessary function in regards to technology assessment for clinical decision making. However, would such an agency have what it takes to provide adequate turnaround, and nonbiased decision-making ability to play this crucial part of the reform process?

The emerging healthcare environmental manager.

The following speech was delivered in November 1991 by Dr. Lerner at the New England American Society for Healthcare Environmental Services [ASHES] regional conference. It concerns issues vital to the management of environmental and occupational health and safety in healthcare facilities and should be read by hazardous materials managers and hospital CEOs alike.

Britain between the wars: the historical context of Bowlby's theory of attachment.

As developmental psychology "comes of age," there is increasing interest in tracing the history of thought and research concerning children (Lomax, Kagan, and Rosenkrantz 1978; Sears 1975; Senn 1975). Such an enterprise offers the possibility of providing not only a descriptive chronicle of personal or anecdotal interest, but a basis for insights into how our ideas have been shaped by the cultural context in which they were developed. It is, for instance, by now commonplace to note that much of Freud's thought should be seen in the context of 19th-century Vienna, and that many of his perceptions may have been correct for the individuals he observed although they may fail as immutable observations of human behavior in general (see, e.g., Mitchell 1974). The present paper explores the cultural and historical context of another major theorist of child development, John Bowlby. The early origins of Bowlby's theory are sought in events set in train in Britain by the First World War, and occurring during the interwar period. This may surprise readers who think of Bowlby's work as beginning with the WHO Report (Bowlby 1951) and consequently as related to the Second World War, to observations by Burlingham and Freud (1942, 1944) of children separated from their families, and to Spitz's (Spitz and Wolf 1946) work on infants in foundling homes and orphanages. But formulations in the WHO report clearly appear in Bowlby's work before World War II and are also evident in the writings of Klein (1935, 1940) and Suttie (1935), who were working on themes first drawn into focus during the first World War. In a personal interview, Bowlby identified 1929 as the time when he was first struck by the importance of separation in children's lives. Thus, this paper focuses on the effect of the "Great War" on psychoanalytic thought and, more generally, on psychiatry in Britain.