Background. Gallbladder diseases, especially cholelithiasis, are extremely frequent in Chile, and an increasing frequency of gallbladder carcinoma has been observed during the last decades. Hyperplastic and atypical epithelial lesions of gallbladder epithelium have been considered potential precursors of invasive carcinoma. The current study was designed to study the frequency, distribution, extension, and probability of routine detection of potentially preneoplastic changes of gallbladder epithelium. Methods. Epithelial changes were histologically studied by mapping gallbladders obtained at elective cholecystectomy for lithiasis in 162 Chilean patients. Results. Antral‐type metaplasia was found in 95.1% of the cases, intestinal metaplasia in 58.1%, hyperplasia in 46.9%, dysplasia in 16%, and carcinoma in situ in 2.5%. A significant association of intestinal metaplasia with hyperplasia, intestinal metaplasia with dysplasia, and hyperplasia with dysplasia was found. Hyperplasia and dysplasia were also present in four cases with carcinoma in situ. Mean extension of the lesions (percentages of the sections in which the change was observed) was antral‐type metaplasia (62.7%), intestinal metaplasia (25.3%), hyperplasia (24.1%), dysplasia (15.5%), and carcinoma in situ (9.7%). Antral‐type and intestinal metaplasia were more extensive and more severe in patients older than 50 years of age. Hyperplasia was more extensive in cases in which it was associated with dysplasia and carcinoma in situ. Conclusions.The extension of metaplasia seems to depend in part on the age of the patients. The association of intestinal metaplasia with hyperplasia and dysplasia agrees with the findings of other authors that relate metaplasia to gallbladder cancer. The epithelial lesions are focal or partially confluent, thus a single random histologic section will detect less than one third of the hyperplasias, dysplasias, and carcinomas insitu.

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In general, psychiatrists disagree about the diagnostic significance of a mother's report of behavior symptoms in her child. This paper is a report of a test of the hypothesis that a significant relationship exists between a mother's report of symptoms and a school-determined estimate of general adjustment in the child, independent of sex and social class differences.

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we have been involved for I about two years in an attempt to plan and carry out a meaningful evaluation of the mental health program in operation in several communities in the county.We wanted an evaluation which would be more nearly objective than a tabulation of judgments about improved mental health in the community. We were aware that this required the resolution of a number of problems which had plagued evaluation research for some years. In reviewing the kinds of problems which have been typical in such research, one might classify them as follows:1. Criteria selection-the identification of the kinds of changes which a successful program should make in the people of the community.2. Hypothesis formation-the statement of hypotheses about the expected changes, which are (a) conceptually clear and valid statements about improved mental health; (b) applicable to all the people of the population sampled; and (c) specific enough to permit valid and reliable measurement.3. Assessment-the development and the empirical validation of efficient methods of measuring the expected changes in the people of the community. 4.Sampling-the selecting of a sample of communities which will permit (a) as broad a generalization of the findings as possible; (b) a definition of the subsamples of people who respond to the program and those who do not respond; and (c) a definition of the population which the total sample represents, and of the subpopulations which the subsamples represent.5. Design-the construction of a research design which will (a) separate the effects of the program from the effects of the many other influences operating in the community; (b) give results independent of the differing conditions under which the program functions in different communities; and (c) permit a definition of the conditions under which the program is successful, and those under which it is not successful.6 . Data treatment-the selection and application of statistical methods of maximum precision and best fit to the form of the design and the data. 7. Reporting-the communication of the findings in a manner appropriate * Presented at the 1955 Annual Meeting in a Round Table on "Research for the Evaluation of Community Mental Health Service," Margaret C.-L. Gildea, M.D., Chairman. The research and service programs on which this paper is based are programs of the St. Louis County Health Department. The investigation is supported by a research grant