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The purpose of this paper is twofold: to enable hospital administrators to increase reimbursement rates under value-based purchasing (VBP) by understanding the process by which the Centers for Medicare and Medicaid Services (CMS) calculate and use performance scores from the Hospital Consumer Assessment of Healthcare Providers and Systems survey of patient experience; to apply statistical methods to determine what dimensions of patient care have the greatest impact on overall satisfaction scores and thus reimbursement.

The expository purpose was met by locating, analyzing and interpreting published CMS documentation related to VBP to explain the complex methods used to convert raw survey data to total patient satisfaction scores on seven dimensions. The raw data on 2,984 hospitals were cleaned and correlation and regression analysis used to measure the relationship between raw survey scores and overall patient satisfaction scores. Finally, Pareto analysis was used to show the relative influence of each dimension on satisfaction performance scores.

Nursing communications accounted for 75 percent of the variance in the patient satisfaction domain score in a stepwise regression.

This research focusses only on the patient satisfaction component of VBP, over which hospital administrators have significant control. Future research could explore how hospital management can improve scores on clinical outcomes, process and efficiency.

Shows hospital management the most influential methods for improving their patient satisfaction scores and reimbursement under VBP.

Offers a managerially focussed explanation of how patient satisfaction scores are computed from raw survey data and how statistical analysis of the data can be used to improve quality.

The purpose of this paper is to demonstrate the significance and limitations of ethical shopping in Britain in the period between the 1880s and 1914 and, in particular, the use of white lists as a means of encouraging consumers only to buy goods produced in satisfactory working conditions.

A brief survey of earlier examples of ethical shopping provides the context for a discussion of the published prospectus of the “Consumers” League’. Unpublished records of the Christian Social Union (CSU), supplemented by newspaper reports, are used to examine the rationale for white lists, their creation and effectiveness.

The paper demonstrates that, contrary to what has generally been thought, consumers’ leagues originated in Britain not the USA. The CSU was not ineffective but provided an ethical and religious rationale for consumer activism. It was also responsible for the creation of white lists in several towns and cities in Britain and promoted the concept of preferential buying. CSU activity helped shape public opinion, but sustained improvements to working conditions also required effective trade unions and government intervention.

Relatively few CSU branch records survive and this precludes a comprehensive survey of its role in ethical shopping.

The British consumer movement in this period has been little studied and often dismissed. By making use of archives, particularly CSU branch records, that have generally been ignored, the paper demonstrates that ethical shopping mattered and deserves more attention. It also highlights the importance of setting this in a wider context, particularly trade unionism and co-operation.

In a lecture of this type it is not necessary to discuss how the various nutrients in food are determined, but it may not be out of place to emphasise that it is misleading to use general terms, such as a broad statement that one food is more nutritious than another. The value of a food in a diet is dependent upon what actual nutrients it contains, and consideration should also be given to the nutrients supplied by the remainder of the diet normally consumed. A diet which provides all the required calories, ample fat, and good quality protein, mineral matter, etc., would be unsatisfactory if it still lacked other essential nutrients such as vitamins. Similarly, no one can live for long on a diet of high calorific value and rich in vitamins if it lacks protein which supplies the body with a wide range of essential amino acids. It is inadvisable to think only in terms of well‐known foodstuffs and simply to say, for example, that milk is very nutritious. Milk is only the excellent food that it is because in general it provides a wide range of essential nutrients such as fat, proteins which supply many amino acids, vitamins such as riboflavin, and useful minerals such as calcium, etc. It is advisable to think in terms of the actual nutrients rather than in terms of the foodstuff itself. Table 1 shows that bread provides a variety of important nutrients, i.e., substances which are essential to the diet if the body is to remain healthy and able to fulfil its normal functions.

Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Term. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.

LOOKING BEFORE AND AFTER : BEFORE Opening, as we do, a new volume of THE LIBRARY WORLD, especially as with it we reach the venerable age of sixty‐one, does suggest retrospective and prospective view. The magazine is the oldest amongst independent library journals, though others existed before 1899 in different forms or under other titles than those by which they are known to‐day. When at the end of last century it was felt that utterances were needed about libraries, unfettered by uncritical allegiance to associations or coteries, librarianship was a vessel riding upon an official sea of complacency so far as its main organisation was concerned. It was in the first tide, so far as public libraries were concerned, of Carnegie gifts of buildings, not yet however at the full flood. The captains were men of the beginnings of the library voyage; who were still guided themselves by the methods and modes of the men who believed in libraries, yet feared what the public might do in its use of them. Hence the indicator, meant to show, as its name implies, what books were available, but even more to secure them from theft, and to preserve men and women from the violent mental reactions they would suffer from close contact with large numbers of books. There were rebels of course. Six years earlier James Duff Brown has turned his anvil shaped building in Clerkenwell into a safeguarded open access library in which he actually allowed people, properly vetted, to enter and handle their own property. This act of faith was a great one, because within a mile or so some 5,000 books had been lost from the Bishopgate Institute Library, which has open shelves, too, not “safeguarded”. Brown's “cave of library chaos” as a well‐known Chairman, who by one visit was convinced of its good sense and practicability, called it, focused the attention of scores of librarians—so much so that Brown had to beg them to keep away for about a year, so that the method might be better judged after sufficient trial. It also focused the attention of the inventors of the indicator, who, presumably, had more than a benevolent interest in its sales. So there was war against this threat and for several years this childish contention raged at conferences, in private conversations amongst library workers, and in letters to the press aimed to convict Brown and all his satellites of encouraging dishonesty, mental confusion and other maladies public. Hence Brown, L. Stanley Jast, William Fortune and others initiated this journal to teach librarians and library committees how libraries were to be run. That, in extreme brevity, is our genesis. For sixty years it has encouraged voices, new and old, orthodox or unorthodox, who had something to say, or could give a new face to old things, to use its pages. Brown was its first honorary Editor, and with some assistance in the later stages remained so for the thirteen years he had yet to live. Nearly every librarian of distinction in his day has at some time or other contributed to these pages. So much of our past may be said and we hope will be allowed.

IN 1846, Charlotte Brontë was attempting to find a publisher for the sisters' first book—a selection of their poems. It was a bad time for poetry. In the earlier years of the century it had flourished remarkably with the rise of Scott and Byron, whose popularity brought record sales, but by the 1840s the demand had declined, and while prose fiction had a reasonable market, poetry was unwanted. Even the arch‐publisher of Victorian poets, Edward Moxon, was not keen to undertake the Poems (1844) of the established Elizabeth Barrett, and showed some reluctance even in the publication of Wordsworth. By 1848 Charlotte had come to appreciate ‘that “the Trade” are not very fond of hearing about poetry, and that it is but too often a profitless encumbrance on the shelves of the bookseller's shop’. It is little wonder, therefore, that of 1846 she later wrote: ‘As was to be expected, neither we nor our poems were at all wanted…. The great puzzle lay in the difficulty of getting answers of any kind from the publishers to whom we applied.’

MID‐OCTOBER sees all library activities in process. The autumn and winter prospects are interesting and, in some senses, may be exciting. The autumn conferences have been held, except that of the London and Home Counties Branch, which is at Southend for the week‐end October 17th to 20th, and is the third sectional conference to be held this month in addition to seven other meetings. These gatherings, at Torquay, Greenwich, Felixstowe, London (three), Tunbridge Wells and Leicester, show a fairly wide coverage of the lower part of Great Britain. The northerners had their go, so to speak, last month, in Durham and elsewhere, as we have previously recorded. The Programme of Meetings, 1952–53, arranged by organisations in the London and Home Counties Branch area, is a most convenient leaflet listing 33 meetings in the area. Every interest seems to be served, with two exceptions, and every L. A. member of whatever section may attend any or all of the meetings. The exceptions are the meetings of ASLIB and the Bibliographical Society. Any list of meetings for librarians would be improved if it noted all that interest them and these would be a useful, not extravagant, addition. London Library Intelligence, the editorship of which has been handed over by Mr. F. J. Hoy, who did it extremely well, to Mr. R. W. Rouse, Borough Librarian, Finsbury, E.C.1, does provide the required information we understand. It is perhaps too much to expect a list of all gatherings throughout these islands; or is it? There are 12,000 of us and, if only 50 attended a meeting once a year—a satisfactory number for discussion— there would be room for 240 meetings.

In 1937, a pictorial fine art map of the University of Toronto was designed and painted by artist Alexander Scott Carter. The map was commissioned by Vincent Massey, then High Commissioner for Canada in Britain, and given as a gift to Hart House. As a vibrantly visual rendition of the university's historical lineage, the map depicts the evolution of the university's various colleges along with its founders, contemporary geographical boundaries, and lush and verdant landscapes. The purpose of this paper is to inquire into its cultural and historical importance.

The paper analyses, and provides a viewpoint on, A. Scott Carter's map.

Carter's map reveals the discursive and visual interpretive frameworks in which the map was situated and the narratives and myths that it sanctioned. The map performs an important function in authorizing the collective identity of the university and its actual and imagined communities. It provides a cultural expression of shared values, ideals, and particular historical traditions. The university's place in the hierarchy and tradition of Canadian higher education in the British Commonwealth is embodied in the map at a time when such ideas were under scrutiny by professors and intellectuals who were arguing for the extrication of Canada from colonial inheritances.

Carter's map highlights the university and its integral cultural artifacts, spaces, and practices as being replete with contested meanings, experiences, and symbolism. Through dynamic cartography, new approaches in deciphering the official and informal campus emerge to produce a nuanced and multifaceted historical picture of university and academic cultures.

“We are really a family concern,” said Mr. John Carter, referring to Routledge & Kegan Paul of which he is chairman; and the same, in different degrees, could be said of the three other London publishing houses which I have been visiting. Longmans and Murrays are eminent examples.