3921 adults randomly selected from across Great Britain were interviewed. Subjects were asked to assess a selection of 10 out of 200 vignettes. Each vignette contained four elements: a category of individual; access to some or all of the health record; specified purpose; and level of patient identifier. Subjects were asked to say how happy they would be to allow access to their health record in the circumstances described.The public were generally happy to provide access to health information. For almost a third of vignettes, subjects said that they would be very happy to allow access to their health information. 9.1% of subjects said that they would be very happy to allow access within all of the vignettes that they were asked to assess. There was however, a significant minority of responses (11.6%) to vignettes where subjects said that they would be very unhappy to allow access. In addition 2.1% of individuals said that they were very unhappy with all of the vignettes presented to them. Individuals from higher social groups, older people and males were more likely to be happy with access to their health information. The individual requesting information was the most important factor determining permission to access health information. Subjects were happier to release anonymised rather than personally identifiable data. Content of the information to be released did not seem to be that important, even when the health record contained sensitive information. With the exception of teaching students, the use of the information wasn't an important determinant of consent.Despite a level of support for use of health information in most circumstances, this doesn't mean that patients don't want to be asked for consent, nor that the views of the small minority can be ignored. The ethical and policy implications of these findings will be discussed.

During 1974, 29 pediatric nurse associates and 15 pediatric nurse associate trainees worked in the child health care system of the New York City Department of Health. All of these nurse associates, formerly public health nurses from the Department of Health, were trained in a one-year, intensive, closely supervised didactic and clinical course.Within the child health units the nurse associates assumed clinical roles in the care of well and sick preschool children according to the written guidelines andWith the introduction of pediatric nurse associates (practitioners), studies oftheir productivity, ofpatient acceptance, and of the quality of their care have documented their potential contribution to the delivery of primary pediatric care. [1][2][3][4] Since pediatric nurse associates are relatively recent innovations in the health field, the absolute number of these new professionals remains small. In the ten years since their introduction, about 3,000 pediatric nurse associates have been prepared for the entire country.5 Few reports have quantified the activity of a significant number of pediatric nurse associates working within a single health care system. This report describes the education and subsequent activity of 44 nurse associates working in the Department of Health in New York City during 1974. protocols of the Department. In addition, they continued to function in the more traditional role of the public health nurse for their own patients, rendering counseling, referral, and follow-up services as indicated. Physicians acted as consultants to the pediatric nurse associates. The Educational ProgramComparisons are made between pediatric nurse associate-physician staff versus public health nurse-physician staff in terms of productivity and cost. (Am. J. Public Health 67: [855][856][857][858] 1977) associates. The students for the proposed programs were public health nurses currently employed by the Department of Health. The Health Department agreed to pay the nurses' full salary and to provide necessary books and equipment during the program. Each student, in return, signed an agreement in which she promised to remain within the Health Department for at least two years upon completion of the educational program. The federal government provided funds to the University for support of the program.The curriculum followed the guidelines for such continuing education courses established by the Americn Nurses' Association and the American Academy of Pediatrics.6 The program was of one year's duration: four months of intensive didactic and clinical experience followed by eight months of internship.During the first four months the students spent approximately 50 per cent ofthe time in didactic session conducted by the University nursing and medical faculty. To make certain that the didactic portion of the course was tailored to the specific policies and procedures of the Department of Health, members of the Department provided sessions on these issues. In addition, the students spent about 50 per cent...

Issue addressed: Aboriginal and Torres Strait Islander peoples inAustralia have an inequitable burden of acute rheumatic fever (ARF) and rheumatic heart disease (RHD), concentrated among young people and necessitating ongoing medical care during adolescence. There is an unmet need for improved well-being and support for these young people to complement current biomedical management. Methods: This pilot program initiative aimed to determine the suitability and appropriate format of an ongoing peer support program to address the needs of young people living with RHD in urban Darwin. Results: Five participants took part in three sessions. Findings demonstrated the peer-support setting was conducive to offering support and enabled participants to share their experiences of living with RHD with facilitators and each other. Satisfaction rates for each session, including both educational components and support activities, were high. Conclusions: Learnings from the pilot program can inform the following elements of an ongoing peer-support program: characteristics of co-facilitators and external presenters; program format and session outlines; possible session locations; and resourcing. So what?: Peer support programs for chronic conditions have demonstrated a wide range of benefits including high levels of satisfaction by participants, improved social and emotional wellbeing and reductions in patient care time required by health professionals. This pilot program demonstrates the same benefits could result for young people living with RHD.

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