Document LK0xGXpox7oQ5y0o5Nze5DXGg

t** QUARTERLY BULLETIN METROPOLITAN NURJEJ Vol.5, Ho.3 July 1941 PLAINTIFF'S EXHIBIT TWIMTI-FIVE METROPOLITAN TEARS | Dr. Armstrong's 25th Metropolitan anniversary, which occurred on Juno lot, was celebrated by the Welfare Division on May 27th. Dr. Lsnsa presented bin with the scroll repro duced on page 2. This pictorial summary of Welfare Division activities was especially appropriate to the occasion, for Dr. Amstrong has had a part In all these developments. His association with the Company began with his posi tion as the Executive Officer of the Framingham, Mass. Com munity Health and Tuberculosis Demonstration in 1916, when the Company made funds available to the National Tuberculo sis Association for this research project. The results of the work in Framingham are well known1 In seven years there was a reduction of 9 percent in the general mortality, 40 percent in the infant mortality, and 68 percent in the tu berculosis mortality, and sinee then the tuberculosis death rate has declined to about one tenth of its pre-demonstra tion level. He was appointed Assistant Secretary of the Company under Dr. Frankel in 1924. In 1929, he was made Fourth Vice-President and following Dr. Frankel*a death in 1931, he became Third Vice-President in charge of the Compa ny's healtn and welfare activities for policyholders. In accepting the Welfare Division's gift designed as a contribution to be forwarded by Dr. Armstrong to New Iork Hospital for the William Robert Williams Memorial Room, Dr. Armstrong expressed his pleasure in being enabled thereby to join in honoring Dr. Williams. He referred to Dr. Williams as an outstanding example of the perfect blend of skill and kindness - one who to a superb degree combined the cold science of diagnosis with the warn sympathetic art of the personal medical guide. MET-450 NURI1NG BUREAU WELFARE DIVIJIQN METROPOLITAN LIFE INSURANCE COMPANY ~^Y "(afar Sxural^r Armsfrtri^.^ll.'X) ^irr~Prrsiiir i;f IN QB COGNITION OP YOUB TWBNTY-PIVB YSABS OP DISTINSUI8MED SBBVICE IN THE MBTQOPOLITAN UPS INSUBANCB COMPANY, THE STAPP OP THI WBLPAB1 DIVISION IN TWG HOMS AND HBAO OPPICSS HAS - THB-HONOB - TO ' PBBSINT TO - YOU A GIPT OP 171 AS A CONTBI0UTION TO BP MAOB IN YOUB NAME * TO THE WILLIAM BOBBBT WILLIAMS MS MOQIAL BOOM IN -THB NEW VOBV HOSPITAL. THE QUlfiTERL! BOLLETIH A SEW DAI FOR INDUSTRIAL NURSING Of interaat and importance to Metropolitan Nurses, because of their contacta with induatriea which have Metropolitan Group Insurance, are two recent developments in the industrial nursing field. The Industrial Hygiene Division of the National Institute of Health, United States Public Health Service, now has a public health nursing consultant. Miss Olive Nhitlock, formerly the public health nursing consultant for District II, United States Public Health Service, was appointed to the new position on March 1, 1941, to assist in the promotion and davelopmant of industrial nursing in de fense industries. A month later the National Organisation for Public Health Nursing appointed as Assistant Director and Consultant on Industrial Nursing, Mrs. D. Irene Bigler of Beloit, Wis. The United States Public Health Service, as a Federal defense agency, will promote industrial nursing through its own public health nursing consultants and the publie health nursing services of State health departments, which in turn will work with local agencies. The week of April 14th an institute was held at the National Institute of Health, Betheeda, Kd. for the eight public health nursing consultants of the Public Health Service, together with the four* re cently appointed Industrial nursing consultants in the Connecticut, Indiana, Michigan and Vermont State health departments, and a selected number of national and State representatives, to review the industrial health situation and get background information relating to industrial nursing. The National Organization for Public Health Nursing is working on a threeyear project which it considers particularly timely in view of the national de fense program. One part of this project will be the development of a manual for industrial nurses. In addition, consultant and advisory services will be given to employers, industrial nurses, and community agencies interested in industrial health problems. Mrs. Bigler will also advise with colleges and universities concerned with the preparation of industrial nurses. Particular attention is to be given to the large proportion of industrial workers who are engaged by plants too small to employ their own doctors and nurses. The effort will be to encourage local agendas - health departments and public health nursing associations - to offer part-time service to such plants. This whole effort should mean increased opportunity for the Metropolitan Nursing Service to improve its nursing program for Insured Groups, as emphasis will be given to the importance of prompt follow-up of the absent employee and the prompt referral of ail sick employees for necessary home nursing care. Miss Bowens Balden, Connecticut State Department of Health, Hartford, Conn. Miss Ruth M. Scott, Indiana State Department of Health, Indianapolis, Ind. Miss Mary Alton, Michigan Department of Health, Lansing, Mich. Miss Esther Martinson, Vermont State Health Department, Burlington, Vt. (Hiss Elsie Handly and Mias Margaret Wilson have been more recently appointed to similar positions by the Missouri State Board of Health, Jefferson City, Mo.) -3- < THE QUARTER!,! BULLETIN THE NURSING BUREAU CONFERENCE The annual conference of the Metropolitan Nursing Service took place In April and, according to custom, at the time of the Managers' Convention. It was probably both the liveliest and the Boat serious meeting in the history of the Nursing Service - lively because most of the Beatings were discussions and seri ous because the group was gravely aware of the world war situation and conscious that the tines demand of all of us the clearest thinking and the most thoughtful effort. "Nursing and National Defense" was the major these of the first full conference day* Dr. Armstrong presiding, called upon Miss Saupt to lead a discussion of "Metropolitan Nursing and the Defense Program." She briefly reviewed two arti cles froa the April issue of Professional Nursing (a publication of the Nursing Information Bureau-of the American Nurses' Association), one entitled, "Vhy More Nurses Are Needed" and the other, "Nhere Are Nurses Needed?" It was recognised that we should consider the possible need for nursing service for policyholders who are newly settled in cantonment sones. The effect of Industrial projects In causing sudden shifts of population to take cars of defense orders is a similar problem which 1s being considered by the Nursing Bureau. Miss Baupt summed up our responsibility thus! To take our place adequately in the defense program we must - Do the job we are doing now as well as possible. Observe trends and learn what is happening In the whole field of public health. Dr. Burnette, Assistant Secretary In charge of Welfare work in Canada, told of the efforts that are being mads In the Canadian defense program to Impress upon public health nurses the value of their work, and also of the prepara tions which are being made for keeping public health nursing up to standard In the event that a large number of this group may enter the military serv ice. Mrs. Elizabeth Vaughan, Assistant Director of the American Red Cross, spoke to the group about current nursing programs of the Rad Cross, such as the home nursing classes, the plan for the development of nursing In emergencies, and the progress of enrollment. Concerning enrollment, the group was interested to hear Mrs. Vaughan's re port of assistance given by the Metropolitan through the Red Cross to the nation al defense program. Members of the Welfare Division and the Statistical Bureau were loaned to the American Red Cross to assist in the analysis of the system of enrolling nurses, and to help plan and put into action a method which would take care of the rapidly increasing enrollment. Applications have climbed froa an average of 100 a month to a recent peak of 1,500. With the new system for han dling enrollment, each completed application can be cleared and sent to the War Department within 48 hours of its receipt. The Army will require at least 5,000 -4- THE Q D A R T E R L I B 0 L L B T I H Borasa by July lat. With tha increasing enrollment, the Red Cross hopes end ex pects to be able to meet this Increased demand for Army nurses. Dr. Lydia Giberson, Industrial Psychiatrist for the Metropolitan, inter preted her work as psychiatrist is tha Hose Office. As to nurses. Dr. Giberson said that their work is of tremendous importance and value in the Industrial phase of the defense program. "Confusion about the issues of the present world conflict is part of the war or nerres. Conviction is the basis of morale. It is therefore important that doctors and nurses should be intelligent and thought ful, should know what they think, and how they stand in this time of national crisis. Their dearness of conviction and their firmness will help the morale of those with whom they come in contact in the industrial group, and if we have a strong morale in that group we have a strong morale in America." Dr. Giberson's inspiring talk led naturally into a discussion of industrial nursing and ths Metropolitan's Group nursing. Miss Ruth Houlton, Associate Di rector of ths National Organization for Public Health Nursing, introduced to the group Mrs. Irene Bigler, recently appointed Consultant on Industrial Nursing in ths N.O.P.H.N. Miss Waterburv gava a summary of ths year's Group nursing axperianca, re ported an Increase in cases and visits, and expressed the hope that our local services would participate even more actively in efforts to kaep Group certifi cate holders well as s real contribution to national defense. Dr. McConnell. Assistant Medical Dirsotor, was such concerned with the problem of the education of industries regarding tha Nursing Service, and made some good suggestions.* Naturally the conference considered many subjects other than those men tioned. The Welfare Division's Bureau Heads took part. Gniifnrd told us what is new in nutrition, and Miss Schawe reported upon her year of field work with the staff. Hannah spoke of the Hursee' pert in literature distribu tion and in Metropolitan campaigns. Miss Crosbr told how to cooperats most helpfully with the Bureau of Social Agencies and Mr. Cole gave an analysis of ths home accident study. Administrative problems were presented briefly by Mlaa Johnson and Mr. Scott. The educational program of the Metropolitan Nursing Service In its many ratifications wee considered by the group with Miss Reid presiding and with Tarritorial Supervisors leading discussions on such subjects as "The Supervi sor's Conference With the Nurse at the Conclusion of a Visit" and "How Can Su pervisors Help Nurses to Promote Family Health?" Miss Mary Connor, Assistant Director and Secretary of the Education Committee of the H.O.P.H.I. was a guest at this session, end spoke briefly of her work. The suggested changes in nurs ing techniques were discussed fully and an excellent demonstration of the pro posed change in the thermometer technique was given by Miss Gertrude Morris, Lo cal Supervisor of ths Queens, L. I. staff. Thase meetings and indeed the whole conference were a demonstration of our belief that discussion is e valuable edu cational aetbod. * Dr. McConnell will embody these suggestions in en article to appear in The 9u*rf"T`lr Bullethq this fall. -5- \ TUZ QCiRTEELI BOLLITIH Two delightful occasions always mark the annual conference. One la Dr. Armstrong' luncheon for Territorial Superrisors, attended aleo by the Welfare Division Bureau Heads and the Administrative Staff of the Nursing Bureau. The guest speaker was Ur. G. W. Fitzliugh, Assistant Actuary of the Metropolitan, who told the group about voluntary prepayment sickness insurance plans. The other high light of Convention week is the ""mi tea given by the Welfare Division for the Metropolitan Managers and their wives. This year with much more floor space available than there has been in recent years, the exhibit display was especially satisfactory and included the new nursing exhibit; a dem onstration of the effect of an adequate diet as compared with an inadequate one on the growth and health of several sets of white rats; an exhibit concerning the Company's new fils, "Proof of the Pudding"; and a display of recent Welfare Division booklets. ANNOUNCEMENT Helen C. La Malle, known throughout the Company as well as in the public health field in the United States and Canada, will retire from the Company's Nursing Service on January 1, 1942. This announcement was made by Dr. Armstrong during the Nursing Bureau conference in April. In a warm tribute to Mrs. La Malle, he said in part, "If it had not been for her. Dr. Frenkel's difficulties and problems in getting the Welfare Division under way, and in getting the Nursing Service established on a firm footing, would have been very great indeed." Dr. Armstrong retraced briefly the history of the Nursing Service and Mrs. La Malle's great contribution to it, first as a Supervisor, then as Superintend ent of Nursing, and more recently as Superintendent of Nursing for the Pacific Coast. "I know you will share with me ay most earnest regrets that she comes to this conclusion and this step. At the same time I expect you will also share with me a feeling of comfort and satisfaction in that she is retiring 'under her own power,' retiring with vigor, health, and an opportunity to enjoy life," said Dr. Armstrong. HOW TO KEEP POUCIHOLDERS AWARE OF THE METROPOLITAN NURSING SERVICE I should like to emphasis# ths value to a Nurse of becoming an active mem ber of the coaanmity in which she is stationed. Many of us know from sod experi ence ths antagonistic attitude so often adopted towards newcomers in old, con servative communities. However, a Nurse who takes her place in ths nursing and social world of ths coaounity she strives to servo has ths best opportunity to keep ths policyholders of that community interested and aware of her. To this and, I recommend faithful attendance at meetings, and ssrvice to the local nurs- THE QUARTZRLI BULLETIN ing organizations; membership in some patriotic, service, and social clubs, and, moreover, a spirit of readiness to render any reasonable service asked by her fellow citizens. Zn this way she will becone known and will arouse the interest of sen, woaen and older children of the community she makes her own. following their interest will come the natural awareness of what she stands for - and fi nally a demand for her services among those entitled to her care. Willa Ahern Niagara falls, Ont., Canada Ve suggest that this also sounds like a good recipe for a contented life. (Ed.) ENRICHED FLOUR AND BREAD Enriched flour* is a new product that is being offered to the American public. This is a first step in a plea for improving the nutrition of the popu lation as a part of national defense. The formula for "enriched flour" was worked out jointly by government authorities, nutritionists, and the milling in dustry. It may bs made by ths addition to white flour of thiamin, nicotinic acid, and iron in amounts approximating those found in flour milled to use 8$ percent of the wheat. It also may be made by Improved processes of HTHwg which retain ths vitamins and minerals present in the wheat. "Siriched bread" may be made from "enriched flour," by the addition of the required vitamins and iron to the bakers' formulas or by the use of special yeasts. In ordar to carry the tern "enriched" on the label, each pound of flour must contain thiamin 1.66 mg., nicotinic acid 6.15 mg., iron 6.15 ag. Enriched bread must contain in each pound of baksd bread not less than 1 mg. nor more than 2 mg. thiamin (from 333-667 international units)} not loss than 4 ag. nor more than 8 mg. nicotinic acid, and not less than 4 ag. nor more than 16 ag. iron. Optional ingredients are riboflavin, vitamin D, and calcium. for many years nutritionists and others Interested in building health have urged that half of the cereal products eaten dally should be of a whole-grain variety. The purpose of this recommendation was to improve the diet in vitamins and minerals. While the use of whole grains by American families has increased, ths aajority still prefers ths nore refined products. Now this aethod has been found to improve whits flour without changing its flavor or its appearance mark edly and usually it is sold at no extra cost. In our teaching, we should urge that all of the white flour used should be of the "enriched* variety. However, whole grains still contribute more nutri ents than ths "enriched flour" doss snd we should continue to stress the impor tance of using some whole-grain products. Elizabeth Guilford, Director Hoae Economics Bureau t i THE QOAETISL! BULLETIN INGENUITIES KELLI PAD I recently had a patient with a draining Incision following an opera tion for a renal abscess. The wound had to be irrigated daily. I took a large brown paper beg, cut off the bottom end, flattened out the bag, and slit one seam up the side. Then I folded the sides OTer once, then over again - to sake the edges firm. (As you will see from the illustra tion, the finished product roughly resenbled a Kelly pad.} Z used water-proof adhesive tape to attach the wider end to the patient's back, ritfit under the incision. A fresh bag was used for each treat* sent. Josephine Stinson New Orleans, La. 1. Wound. 4. Basin for 2. Adhesive tape. waste. 3. Paper bag. 5. Stool or chair. NEW USE FOB A COOK BOOK Alice M. Roberta, Metropolitan Nurse of Dover, Del., saw an autonobile swerve froa the road and hit a concrete bridge abutment. On Investigation she found that the driver had fractured his wrist. She used two folded cook books for splints and bound them Into place with the injured nan's fishing line. An other passer-by took him to the hospital. NEWS REEL PUBLIC HEALTH NURSING IN PICTURES Hiss Baupt and Hiss Hirsch, Territo rial Supervisor for the Great Lakea Territory, attended sessions of the convention of the National League of Nursing Education in Detroit, the week of Hay 26th. Tha new nursing exhibit which was "previewed" at the Hanagers' Convention, was displayed In Detroit and aroused ouch interest. This 10-foot exhibit, which is di vided into three panels, has some beautifully planned and artistically photographed pictures of public health nursing in action. It is ap propriate for use by any visiting nurse organisation and is also avail able for State and District meet ings. THE QCARTERLI BULLETXV ANNIVERSARIES AND MEDALS In this number of The Quarterly bulletin we publish the nsme6 of a group of Nurses who have recently celebrated Metropolitan anniversaries and have received Service Medals. Alice Ahern, Assistant Superintendent of Nursing in Canada, celebrated her 20th anniversary on March 1st. The success of the Thetford Mines demonstration which Miss Ahern organised, led to a position as Nursing Field Supervisor and in 1924 she was appointed Assistant Superintendent of Nursing in charge of the Canadian Territory. During the Nursing Bureau conference. Dr. Armstrong took the opportunity to pay Miss Ahern a well-deserved tribute for her 20 years of fine service. 20 Tears Service Alice Ahern Elisabeth Davie Canadian Head Office Home Office IS Years Service Mary B. Brightwell Mabel Henningsen Rosanna Lalande Martha McEntire Nells H. Myers Ruth N. Olson Easel Southworth Blanche Therrien Lynchburg, Va. Hudson County, N. J. Montreal, Qua. Ogden, Ct. Hagerstown, Hd. Washington, Fa* Hew Castle, Pa* Montreal, Qua. 10 Tears Service Easel AUyn Eudora Felix Alexandria, Va. Chicago, ZU. 5 Tears Service Bmoa Jane Breeden Rebecca M. Comings Adrienne Ellison Bessie Marshall Bessie K. Massey Gastonia, I* C. Harvey, 111. Tampa, Fla. Knoxville, Tenn. Roanoke, 7a. Elizabeth Davie, who celebrated her 20th anniversary in April, came to the Nursing Bursau on April 1, 1921. She has been a Staff Hurse, and a Professional Reviewer. She has had several years of experience in tbs Medical Division as one of the group of Nurses who visit sick employees. Sines 1935 ahe has been a Correspondent in the Burslng Bureau. The title *Correspondent" will convey lit tle idea of the range and high quality of her work. She handles work which must be done exactly right; she does it thoughtfully and quietly. She has been in charge, for instance, of the business of srranging for the transfer of the staff of Nurses in Cincinnati to other Center*. -9- i THE QUARTERL7 BULLETIN Eleanor fair, Research Librarian in Medicine and Public Health, celebrated her 15th anniversary in May. Miss Fair not only sends Metropolitan Nurse* the books they ask to borrov, orders those they wish to buy, and suggests saterial for talks they wish to give, tut she also helps people, especially those in the Medical and Welfare Divisions, with bibliographies and material for papers and articles. She supplements their work and does it with rare good humor as well as professional skill. To Miss Ahern, Mrs. Dari*, and Miss Fair and to all who have celebrated an niversaries recently, The Quarterly Bulletin extends congratulations and best wishes. STUDENTS FOR THE SUMMER The following Nurses will soon be starting work in summer school. We hope each one will have a rich experience and will return to her Nursing Center with fresh enthusiasm and an increased store of knowledge. Name Center College Catherine Denning Grace H. Endera Edna Flannery * Patricia McCoy Eleanors Moore Elisabeth Phillips Bernardin* Striegel Dorothy Winters Hudson County, I. J. Towaon, Md. Warren, 0. Peakskill, I. 7. Oklahoma City, Okla. Kalamazoo, Mich. Territorial Supervisor Fulton, N. 7. Western Reserve University Catholic University Western Reserve University New 7ork University George Peabody College Western Reserve University Teachers College, Columbia Syracuse University * Nurse awarded a scholarship. A NEW USE FOR AN OLD DEMONSTRATION Recently tha Los Angeles County Medical Society conducted a Health Defense Exposition in the Auditorium in Los Angeles. The Metropolitan exhibit consisted of a demonstration of nursing care in the home with special reference to the care of contagious disease given by teams of the Company's Nurses from the Los Angeles staff. The booth was furnished to look like two rooms In an ordinary home, one of which was a bedroom with a Chase doll In the bed as tha patient. The Nurses demonstrated tha bedside ears of tha patient, tha establishment of tha isolation area, the disposal of wests, sad tbs proper use of the gown. A display of im provised equipment for the sickroom attracted much attention. There was also a display of literature, and many requests for copies of pamphlets were received. Approximately 3,000 people visited the exhibit and demonstration and showed great interest. This project was under tha direct supervision of Mrs. Roberts and Mrs. Hodgdon, was planned and carried out by Miss Katherine Laux, Local Supervisor of the Los Angeles Metropolitan Nursing Service. U>- TEE QUARTER!.! BULLETIN FIELD TRIPS Dr. George M. Wheatley, appointed Aaaistant Medical Director in the Wel fare Dixie ion in January, has been observing Metropolitan Nursing in the Field. His firBt experience was with the Queens, L. I. staff when Angela de Costa took him xisiting in her District. Then with Miss Mildred Lee, Territorial Supervisor, he visited the Newton District Nursing Associa tion in the Nov England Territory, and the Metropolitan staff in Malden, Mass. All this was in preparation for a trip to the Pacific Coast where he will assist Dr. Shepard in promot- ing the caapaign against diabetes, and have an opportunity at first hand to observe the admirable relationship which Dr. Shepard has developed and aaintalned, within and without the Company, in his territory. With the annual conference success fully concluded. Miss Margaret Reid, Educational Director, started her long anticipated Field trip which took her to St. Louis, Mo., Denver, Colo., and the Pacific Coast. She assisted with a series of Metropolitan institutes, and also attended the nestings of the western branch of the American Public Health Association in San Diego, Calif., the week of May 26th* In May and June Miss Ruth Vaterbury, Group Nursing .Supervisor, visited Nursing Centers in Georgia, Alabama, Missouri, Tennessee, and Texas in the interests of Group Nursing* Miss Marie Johnson, Assistant Direc tor of the Nursing Bureau, recently spent a week in the Held with Miss Marjorie Adams, Territorial Supervi sor, visiting Centers la Western New Iork. ..... Mrs. Jean Roberts, Assistant to Mrs. La Malle in the Pacific Coast Head Office, spent six weeks in and around the Home Office in March and April, preparatory to Field work on the Coast. In the Home Office she was introduced to the intricacies of cost statements, learned some of the fine points of record reviewing, got ac quainted with statistical analyses, and had many conferences about staff education and related matters. In New Tork, she met leaders in the fields of nursing and of health, vis ited the offices of the national nursing organizations, the American Public Health Association, and the National Tuberculosis Association. She went to Washington on April 16th to attend the Conference on Industri al Nursing and made contact with the American Red Cross, the United States Public Health Service, and the Chil dren's Bureau. The Nursing Bureau conference was the climax of a full six weeks for Mrs. Roberts. She has returned to the Pacific Coast Territory with our best wishes and our sincere regards. Miss Haupt was a guest of the Public Health Nurses of Nassau County, L. I. at their Silver Jubilee dinner on May 7th. This organization has a record of 25 years of working together for the health of Nassau County. Monica Moore, Local Supervisor of the Eastern Long Island Metropolitan Nursing Service, managed to make this affair a double celebration for the staff by saving service medals for presentation by Miss Haupt. The Met ropolitan group gathered at the home of Mrs. Helen Meyer, who has been ill -11- V TBS QOiSIERLZ BDLIZTIH for several wonthe bat 1s now *lowly regaining bar health. Ten-jeer aedals were preaented to Mra. Meyer, Mlaa Madeline Will, Mlea Bridle Smyth, end Mias Clare Curran, end a fireyear aedal to Mra. Harriet Meek. On July 1, 1941, the Visiting Nurse Association of Cincin nati takes orer the nursing care of Metropolitan policyholders in that city. The staff Nurses of the Metropolitan Salaried Serrice there hare been transferred to other commities, with the exception of two Nurses who wished to sake other plans. A new Office is being set up in Newport, Ky. in charge of Miss Sara Rardon, who has been Bead Nurse of the Cincinnati staff. Miss Rardon will hare a staff of fire Nurses froa the Cincinnati Office just across the Ohio Rirer, and Mrs. Catherine White will continue her work as the efficient Nursing Office Clerk. BOOK EBBS CANCER AMD ITS CARE To those who followed the suggestion in the January number of The Quarterly Bulletin and sent for a booklet called Answers to the Public^ Questions on Can cer. we recoasaend another publication, Cancer and Its Caret A Handbook for Nurs es. Prerlous editions of this little book hare been used by oany nurses. As the book has been rerised recently it is sore useful than ewer. Ve like its bunaa tone. The nurse is reminded "that cancer nursing is such the sane as the care of any nodical or surgical case, with the exception that the terminal case requires more patient and tender care because of the long du ration of the disease, the distressing disabilities, and the physical and aental suffering.* The primary purpose of this handbook is the presentation to nurses of authoritatire information on cancer. Send a 3-cent stamp to The American Society for the Control of Cancer, 350 Madison Avenue, New Tork, N. I. if you wish this booklet or the one previously suggested. 12-