1
916 Some of these have now developed mammary tumours, but the results, together with control observations, are still incomplete. The value of the controls in this instance is to exclude the possibility that the test mice themselves carry the tumour agent. Some of the susceptible hybrids do so although they are supposed not to ; therefore all must be suspect: The original report mentioned the absence of particles in extracts of mammary tumours caused by methyl- cholanthrene. It might be extremely valuable if the observers could continue to examine concurrently. extracts from spontaneous tumours due to milk factor, extracts from carcinogen-caused tumours of the mammary gland, and also milk from the stomachs of young mice suckling either a mother with -a primary tumour of the mamma of chemical origin or, if this is impossible, bearing a transplanted tumour of chemical origin. The mammary gland of the mouse and the skin of domestic rabbits are at present the only sites from which data relating to mammalian tumours caused by virus and by chemical means can be collected and compared. In the present state of our knowledge it seems important to find out whether any minute agent is associated with the chemically-caused tumours. G.N.C.’S REPLY TO WORKING PARTY IN their comments on the Working Party’s report, the General Nursing Council, as befits the statutory licensing body of the profession, have concentrated on the recommendations dealing with the nurse’s training, and with their own functions and constitution. Towards most of the proposals their attitude is tinged with reserve. Two years they hold to be inadequate even for a basic training, for it would allow the student nurse to spend only 30 hours a week for 51 weeks on nursing practice. Further the elimination of repetitive duties on which the proposed reduced training is based would rob the student nurse " not only of the ability to nurse but of satisfaction in nursing." The council also disapprove of the proposal that a license to practise should be issued after two years’ training (followed by State registration) and a third year under supervision. Accord- ing to this plan, they say, a nurse who chose public health as her specialty would be entitled to nurse any type of patient after having spent only 18 months of her training within a hospital, while the difficulties involved in ensuring that people who had not obtained the licence did not nurse without supervision would be almost insuperable. With the general content of the training suggested by the Working Party the council are in agreement, and they set out recommendations for a three-year course which they would consider adequate. Such a training would, however, be basic, as compared with their previous proposals for a four-year comprehensive course, and the nurse would still be required " to establish her knowledge and practise her skill." The council think that any type of hospital-general, sick children, tuberculosis- might act as the major school of a training group, the minimum period to be spent by the student in each branch being laid down by the council. Under this system they propose that the present affiliated and associated schemes of training should end, and that the supplementary parts of the register should be closed with the exception of the register of mental nurses. For mental nurses they suggest a three-year course consisting of 18 months’ basic training as laid down in the Working Party’s report followed by 18 months’ training in mental nursing. A general-trained nurse who wished to qualify as a mental nurse would have to take the full additional 18 months’ specialised course. The’education and examination committee of the council add that they see no reason why eventually all mental nurses should not undertake the full course in general nursing : the register for mental nurses would then also be closed. But the mental-nursing committee are emphatic that this is not at present practicable. Turning to the Working Party’s proposal to set up national advisory committees for nursing, the council emphasise that as the statutory body responsible for the examination of nurses they must also be responsible for th& education of nurses. Confusion would be created - throughout the country unless they continued to lay down national standards for admission and training, and inspection of training schools must remain under their jurisdiction. Their functions could well, they suggest, be widened to empower them to " encourage research into training measures and ty approve the conduct of experiments relating to nursing training within training schools." The proposal that there should be one General Nursing Council for Great Britain they turn down as too unwieldy : it is already possible for the Ministers of Health and Education and the Privy Council to appoint members representative of the universities. They agree that the recruitment of assistant nurses is unsatisfactory, but to discontinue this grade of nurses would result in the care of chronic sick being entrusted chiefly to untrained people. The two years’ training of the assistant nurse cannot be reduced, but her remuneration might be increased to balance her limited prospect of promotion. It will be necessary to have an ancillary service of ward orderlies but not nursing orderlies. The council end by drawing the Minister’s attention to the fact that the report of. the Working Party would appear to have been drawn up with insufficient thought of the needs of the patient which in fact form the basis on which any conclusions relating to nurse training must be built." It seems, however, that one may think at length about the patient’s needs without going far enough to meet them. WATER POLLUTION RESEARCH PREVENTIVE medicine has many angles and the report of the Water Pollution Research Laboratory shows how closelv its varied work concerns our health and welfare. The growth of industry, whether in Britain or in the actively developing parts of the Empire, such as East Africa, raises problems of water pollution which can be solved only by experience and patient investigation. Proper methods of waste disposal have greatly helped in the control of many infections, but epidemiologists think there is still much to be learnt about disease by studying sewage. The modern sewage plant with its percolating filters attracts flies, and the new insecticides such as D.D.T. and ’ Gammexane’ are being used to destroy them. Chlorination of sewage effluents has always seemed desirable, but substances toxic to fish and other organisms may be formed in the process. Effluents from many sorts of industrial plants cause trouble, and the removal of cutting oil from machine tools or of pollution from sugar-beet factories are among the recent problems which the laboratory has had to tackle. Its chief aim, however, is research of a fundamental character. THE Ministry of Health announces that 10,459 general practitioners in England and Wales had joined the medical lists of executive councils by June 5. A week earlier the total was 6209. THE Royal Society is holding in London from June 21 to July 2 a Commonwealth conference on the distribution of scientific information. The work of the conference will be divided into four sections dealing with publication and distribution of papers reporting original work; abstracting services; indexing and other library services; and reviews, annual reports. &c. Further information may be had from the assistant secretary of the society, Burlington House, W.I. 1. Report of the Water Pollution Research Board for 1946. Depart- ment of Scientific and Industrial Research. H.M. Stationery Office. 1948. 1s.

G.N.C.'S REPLY TO WORKING PARTY

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916

Some of these have now developed mammary tumours,but the results, together with control observations, arestill incomplete. The value of the controls in thisinstance is to exclude the possibility that the test micethemselves carry the tumour agent. Some of the

susceptible hybrids do so although they are supposed notto ; therefore all must be suspect:The original report mentioned the absence of particles

in extracts of mammary tumours caused by methyl-cholanthrene. It might be extremely valuable if theobservers could continue to examine concurrently.extracts from spontaneous tumours due to milk factor,extracts from carcinogen-caused tumours of the mammarygland, and also milk from the stomachs of young micesuckling either a mother with -a primary tumour ofthe mamma of chemical origin or, if this is impossible,bearing a transplanted tumour of chemical origin. The

mammary gland of the mouse and the skin of domesticrabbits are at present the only sites from which datarelating to mammalian tumours caused by virus and bychemical means can be collected and compared. Inthe present state of our knowledge it seems importantto find out whether any minute agent is associatedwith the chemically-caused tumours.

G.N.C.’S REPLY TO WORKING PARTY

IN their comments on the Working Party’s report,the General Nursing Council, as befits the statutorylicensing body of the profession, have concentrated onthe recommendations dealing with the nurse’s training,and with their own functions and constitution. Towardsmost of the proposals their attitude is tinged withreserve. Two years they hold to be inadequate even fora basic training, for it would allow the student nurse tospend only 30 hours a week for 51 weeks on nursingpractice. Further the elimination of repetitive duties onwhich the proposed reduced training is based would robthe student nurse " not only of the ability to nurse butof satisfaction in nursing." The council also disapproveof the proposal that a license to practise should beissued after two years’ training (followed by State

registration) and a third year under supervision. Accord-ing to this plan, they say, a nurse who chose publichealth as her specialty would be entitled to nurse anytype of patient after having spent only 18 months ofher training within a hospital, while the difficultiesinvolved in ensuring that people who had not obtainedthe licence did not nurse without supervision would bealmost insuperable.With the general content of the training suggested by

the Working Party the council are in agreement, andthey set out recommendations for a three-year coursewhich they would consider adequate. Such a trainingwould, however, be basic, as compared with their previousproposals for a four-year comprehensive course, and thenurse would still be required " to establish her knowledgeand practise her skill." The council think that anytype of hospital-general, sick children, tuberculosis-might act as the major school of a training group, theminimum period to be spent by the student in eachbranch being laid down by the council. Under this

system they propose that the present affiliated andassociated schemes of training should end, and that thesupplementary parts of the register should be closedwith the exception of the register of mental nurses.For mental nurses they suggest a three-year course

consisting of 18 months’ basic training as laid down inthe Working Party’s report followed by 18 months’training in mental nursing. A general-trained nurse

who wished to qualify as a mental nurse would have totake the full additional 18 months’ specialised course.The’education and examination committee of the counciladd that they see no reason why eventually all mentalnurses should not undertake the full course in generalnursing : the register for mental nurses would then also

be closed. But the mental-nursing committee are

emphatic that this is not at present practicable.Turning to the Working Party’s proposal to set up

national advisory committees for nursing, the councilemphasise that as the statutory body responsible for theexamination of nurses they must also be responsible forth& education of nurses. Confusion would be created -throughout the country unless they continued to laydown national standards for admission and training, andinspection of training schools must remain under theirjurisdiction. Their functions could well, they suggest,be widened to empower them to " encourage researchinto training measures and ty approve the conduct ofexperiments relating to nursing training within trainingschools." The proposal that there should be one GeneralNursing Council for Great Britain they turn down astoo unwieldy : it is already possible for the Ministersof Health and Education and the Privy Council to appointmembers representative of the universities. They agreethat the recruitment of assistant nurses is unsatisfactory,but to discontinue this grade of nurses would resultin the care of chronic sick being entrusted chiefly tountrained people. The two years’ training of the assistantnurse cannot be reduced, but her remuneration might beincreased to balance her limited prospect of promotion.It will be necessary to have an ancillary service of wardorderlies but not nursing orderlies.The council end by drawing the Minister’s attention

to the fact that the report of. the Working Partywould appear to have been drawn up with insufficientthought of the needs of the patient which in fact formthe basis on which any conclusions relating to nursetraining must be built." It seems, however, that onemay think at length about the patient’s needs withoutgoing far enough to meet them. _

WATER POLLUTION RESEARCH

PREVENTIVE medicine has many angles and the

report of the Water Pollution Research Laboratoryshows how closelv its varied work concerns our healthand welfare. The growth of industry, whether inBritain or in the actively developing parts of the Empire,such as East Africa, raises problems of water pollutionwhich can be solved only by experience and patientinvestigation. Proper methods of waste disposal havegreatly helped in the control of many infections, butepidemiologists think there is still much to be learntabout disease by studying sewage. The modern sewageplant with its percolating filters attracts flies, and thenew insecticides such as D.D.T. and ’ Gammexane’ arebeing used to destroy them. Chlorination of sewageeffluents has always seemed desirable, but substancestoxic to fish and other organisms may be formed in theprocess. Effluents from many sorts of industrial plantscause trouble, and the removal of cutting oil from machinetools or of pollution from sugar-beet factories are amongthe recent problems which the laboratory has had totackle. Its chief aim, however, is research of afundamental character.

THE Ministry of Health announces that 10,459 generalpractitioners in England and Wales had joined themedical lists of executive councils by June 5. A weekearlier the total was 6209.

THE Royal Society is holding in London from June 21 toJuly 2 a Commonwealth conference on the distribution ofscientific information. The work of the conference will bedivided into four sections dealing with publication anddistribution of papers reporting original work; abstractingservices; indexing and other library services; and reviews,annual reports. &c. Further information may be hadfrom the assistant secretary of the society, BurlingtonHouse, W.I.

1. Report of the Water Pollution Research Board for 1946. Depart-ment of Scientific and Industrial Research. H.M. StationeryOffice. 1948. 1s.