In this project an attempt will be made to upgrade medical care in the State of Maine through the use of open-circuit television. Television is a possible medium for bringing the teaching programs of university hospitals to the practicing physicians who do not take part in established postgraduate educational programs, but who are most active in out-of-hospital care such as home care, nursing-home care, care of the aged and the chronically ill and disabled. Educational TV facilities are available and can reach over 90 percent of Maine's physicians. A series of 16 one-half hour presentations yearly is contemplated. Evaluation of television as a method of postgraduate education will be included as a research portion of the project.

A project to demonstrate the feasibility of a comprehensive program of medical care and rehabilitation for unhospitalized patients with chronic respiratory disabilities. A regional teaching facility will be established to provide training opportunities for professional personnel in evaluation, treatment, and rehabilitation of the respiratory disabled. It is also proposed to demonstrate the value and adaptability of this program as a community service in other areas of New Jersey.

A project to demonstrate a comprehensive training program for planners and operators of coordinated home-care programs. Through expansion of the homecare program of the hospital, selected professional health personnel are to be trained in organizing and operating home-care programs. Both short-term and long-term training is made available for several types of trainees, including community leaders who are expected to stimulate and influence coordinated homecare services. The chief focus of the training will be to orient the trainees in proper untilization of community resources to meet homebound patients' needs, with particular reference to home-care services.

Support is given under this project for the production of an educational film to assist in preparing nurses for better understanding and improved care of the chronically ill and aged in their homes. The film will be produced by Vision Associates, Inc., New York, on a contract basis. Because of the increasing numbers of persons over 65 years of age with chronic illness and the trend toward

caring for them in their homes, it is felt that the film will be of assistance to agencies which are expanding their programs or developing new programs on care of the sick and aged at home and to schools of nursing, both in hospitals and universities. The Visiting Nurse Service of New York will be responsible for promoting wide distribution of the film either through the American Nurses Association, National League for Nursing Film Service, or through some other channel.

This project will establish a training center within the Home for Aged and Infirm Hebrews of New York to prepare qualified health professionals to handle special problems of the aged and aging. Courses will be offered by the institution's professional staff as well as a group of invited faculty instructors utilizing other community agencies for demonstration purposes. Evaluation will be based on the enthusiasm with which the program is received by the personnel being trained.

In this project a small professional staff will recruit, train, and supervise approximately 100 volunteers in a variety of health-assistance tasks. Referrals for service will come from nearby clinics and hospitals, public housing management, the Department of Welfare, private agencies and individuals. Help will be given to the homebound with light housekeeping, shopping, and meal planning. Escort service will be provided in connection with outpatient treatments, and home visits will be paid to convalescents and incapacitated. A participant-observer will record and analyze referral and training procedures and evaluate services rendered. An advisory council representing area agencies will review progress and guide activities.

This project will establish a training and information center for home care and related community services for the chronically ill for planning, developing, conducting, and evaluating a series of educational experiences toward providing orientation in the establishment, operation, and improvement of coordinated home-care programs and related out-of-hospital services. The program will be geared to multidisciplinary groups as well as individual professions. Methods will include courses in teaching specifics, planned institutes, seminars, and workshops.

Because the medical student's horizon of illness is being increasingly limited to the clinic or hospital setting surrounding a patient, the objective of this project is to improve the understanding of these students about certain aspects of chronic disease. The medical student usually has little appreciation of the fact that patients return to a social setting which may importantly influence the course of the disease. He often delegates to the social worker the job of agency referral, often never discovering which agencies were chosen and why, nor what agency functions and limitations may be, and while he has the opportunity to study the diagnostic and therapeutic aspects of chronic disease, its social, financial, and epidemiologic aspects are ignored. Training will consist of observations of various community health problems and programs, field placement, and a written report of a study conducted during the training period. Evaluation will be based on the number of students seeking training, the content of the training experience, the quality of the student projects, and the amount of service performed for various community agencies.

The university will develop criteria and text material for a program of instruction of nursing home administration personnel by correspondence. The general purpose will be to develop courses which can be undertaken in many locations throughout the Nation with an aim to providing students with administrative understanding which might help them meet the standards required by the States in which they are located. Also to be developed is a screening test for applicants which will give an inclination of the level of instruction which should be offered, and a methodology for evaluating the text used and the instructional methods employed.

This project will investigate and evaluate the dental health care requirements of the people of Puerto Rico and formulate an effective plan to provide such services. It will be a pilot project to be used as an example to establish like facilities and procedures in all municipalities in Puerto Rico. Personnel will be trained at the University of Puerto Rico and will then form the nucleus to staff succeeding facilities.

This project will be a study to improve the quality of emergency transportation and immediate care available to the sick and injured, the study to cover all 55 counties of West Virginia. The first phase will determine the current status of emergency transportation, the second phase will consist of a training program to be developed and conducted by the staff of West Virginia University Medical Center in cooperation with the sponsor and other nonofficial organizations to raise the training level of ambulance drivers and crews. The third phase will consist of continuing educational efforts and development of a demonstration program for emergency services in a well-organized community selected on the basis of the

survey.

This project will recruit and train nonprofessional teenagers and adults to provide appropriate homemaker services to persons who are handicapped. Basic and advanced training courses will be standardized, with a flexible outline of content which can be adjusted to community resources as well as to range of age and intellectual and cultural levels of understanding of the trainee. The prime objective is to help the trainee feel more comfortable around persons who are physically, mentally, or emotionally "different," through development of a greater understanding and acceptance of the individual as a person, with the disability being seen in its proper perspective. The ultimate goal of the project is to demonstrate the value to a community when trained nonprofessionals are made available to all handicapped persons who might benefit from their services.

This project will establish a training program in home care as a joint endeavor of the University of Michigan School of Public Health and the Visiting Nurse Association of Detroit. The training program will consist of four 4-day institutes in each of 3 years. Materials developed will be published, and later developed into a training manual which should be of value to communities interested in developing home care services in the future.

The project objective is to write programed instructional material for persons with diabetes mellitus, administer it to a selected group of patients, and evaluate its effect on diabetes control, pateint learning, and patient attitude. The proposed programed instructions will incorporate the actual performance of the desired behavior as an integral part of its structure in the expectation that this may lead to improved self-care and control of the diabetes, as well as to an increased knowledge of the facts about diabetes. Evaluation of the programed course will be through trial use, item analyses, and revisions.

The Wisconsin State Board of Health will develop and conduct a 4-month course to train certified occupational therapy assistants as activity program directors in nursing homes. The course will follow guidelines established by, and will seek the approval of, the American Occupational Therapy Association. Priority for admission will be given persons presently functioning as activity program directors, with second and third priority given other employees of nursing homes

and unemployed persons, respectively. After thorough evaluation of the project, if a need for continuation of the course has been demonstrated, it will become an integral part of the State board of health program activities.

The project will establish a demonstration training center for home care and other out-of-hospital services to train members of the health professions and related groups in the principles of organization and operation of the out-of-hospital health care programs that serve the long-term patient. It will also collect and exchange information about organized out-of-hospital services, and report on research in programing, administering, and evaluating these services. The training program is designed to offer a variety of training opportunities geared to the total area of home care.

This project will demonstrate methods of training homemakers using home economics teachers and will develop curriculums for training homemakers in different kinds of communities. Special training workshops will be established for home economics teachers selected to teach community training classes for homemakers who are adaptable and willing to give homemaking services in families seeking assistance in the care of the aging or the chronically ill. After 3 years of the project, it is estimated that 125 home economics teachers will be trained for leadership responsibilities in community training programs of homemakers, and more than 125 communities will have had opportunity to experience and appraise these programs. Contributions of trained homemakers are hoped to alleviate the personnel shortage in nursing homes and hospitals and in providing medical, nursing, and welfare services.

The first phase of this project will evaluate the present level of emergency medical services in the State. By appropriate community education, the grantee hopes to stimulate and continue public awareness to the needs in emergency medical services, and to provide training for those persons from a community involved in emergency medical services. Reevaluation of the emergency medical services after proper training has been instituted will determine if the level of service has been raised.

The purpose of this project is to provide opportunities for students in the basic curriculum and the graduate programs in physical therapy to develop the knowl