走出"性"的误区

我们经常遇到由于对"性"事处理不当引起夫妻性生活不和谐的情况.80%的人对"性"事处理不当,是出于以下两种原因:一是对"性"观念的理解存在一定的误区;二是缺乏正确的"性"知识.     

"狠心"的德国妈妈

玩游戏也要节约"子弹" 我租住的是一个三层小楼,房东名叫玛丽,是个寡妇,一个人带着儿子约翰尼生活.一天,我到玛丽房间交房租,看到约翰尼正热火朝天地坐在电脑前玩射击游戏.玛丽一边和我聊天,一边关注着"前线"的战况,及时为约翰尼颁布口头嘉奖令.在妈妈的鼓励下,小家伙越战越勇,捷报频传:"报告妈妈,我又过了一关!""报告妈妈,我换装备了!"就在这时,玛丽突然对儿子道:"约翰尼将军,请马上停止战斗!"约翰尼马上按下暂停键将游戏定格,扭过头来一脸迷茫地望着妈妈.我也十分不解,只见玛丽脸上毫无笑容,严肃地说:"刚才那架飞机,明明一枚导弹就能将它击落,你为什么要用三枚?你知道一枚导弹的价格是多少?至少300万马克.你知道现在世界上还有多少人饿着肚子等待救济?你……"     

"专转本"学生心理问题成因分析及预防措施

我国的高等教育已经由精英教育阶段过渡到大众化阶段.近年来,随着独立设置的高职、高专院校的发展,专科教育的规模正在逐步扩大,其对社会的影响进一步明显.在专科学生中选拔适量优秀学生进入本科学习(即"专转本"),既能激发广大专科学生的学习动力,又能满足社会对高素质应用性人才的需要,但受周围环境影响,"专转本"学生心理上承受着巨大的压力,如何加强"专转本"学生的心理健康教育值得我们深入研究.     

自拟"梅山甘露饮"治疗口疮

目的:对自拟"梅山甘露饮"治疗口疮的探讨.方法:对30例以口舌点状溃烂,并具凹、黄、红、痛等特征的患者运用"梅山甘露饮"进行里治疗.结果:治愈15例,显效11例,好转4例.结论:此法改善口腔粘膜之充血水肿,促进溃疡愈合.     

医学微生物学"项目-导师制"实验教学改革初探

目的:探讨"项目-导师制"实验教学改革效果及其在医学微生物学实验教学中应用价值.方法:采用"项目-导师制"法对2001级学生进行医学微生物学实验教学,以无记名问卷调查和专家评议方式了解实验教学效果,以现场操作了解学生实验技能,以相对标准化试卷综合测试学生成绩,并与2000级学生医学微生物学实验教学效果、实验技能、考试成绩进行回顾性和对比分析.结果:2001级和2000级学生实验教学效果不满意、满意、很满意率分别为0%(0/180)、25.00%(45/180)、75.00%(135/180)和55.38%(72/130)、34.62%(45/130)、10.00%(13/130),差异有显著性(P＜0.01).实验技能考核及格、良好、优秀率分别为0%(0/180)、22.22%(40/180)、77.78%(140/180)和56.92%(74/130)、35.38%(46/130)、7.69%(10/130),差异有显著性(P＜0.01).综合考试成绩不及格、及格、良好、优秀率分别为0%(0/180)、17.78%(32/180)、47.22%(85/180)、35.00%(63/180)和154%(2/130)、38.46%(50/130)、52.31%(68/130)、7.69%(10/130),差异有显著性(P＜0.01).结论:"项目-导师制"实验教学是一种新型实验教学模式,可显著增强实验教学效果,帮助学生快速掌握实验技能,提高学生综合考试成绩,克服传统实验教学存在的一些弊端,具有应用推广价值.     

春天的"风"与"风 病"

冬去春来.天气逐渐回暖.人体新陈代谢由低潮开始复苏.汗孔开泄,血管扩张.春风吹来,许多人开始脱去厚厚的冬装.故"风"(寒气)能长驱直入人体,令人感觉.透心凉"-这便是春天风"硬"的道理.寒风可侵犯皮肤、肌肉、关节、经络和血管,诱发多种疾病.中医统称为"风病".     

英国 "健走线"最流行

1.开会线-渴望"边走边谈" 英国利物浦约翰摩尔大学为了鼓励员工放弃会议室,到室外开会,专门委托一家名为"都市行走"的公司制定了几条适合"边走边谈"的路线.该大学负责人说:"在大会议室内长时间开会,     

中医疗法创新探讨——展望"物理促渗技术"与"奇兵疗法"相结合

本文作者对中医疗法的创新作探讨一是"物理促渗技术"与笔者在上世纪80年代所研创的"奇兵疗法"在方法和目的方面竟有殊途同归之处:二是物理促渗法运用高新电子监控技术的经验,使笔为完善"奇兵疗法"解决所遇难题,有了借鉴探索方向.     

当"性福"遇上"第三者"

一位资深婚姻心理专家说:"一对在生活中有太多压力的夫妻,如果再有小孩的话,性爱就很容易被忽视了,过去,你的夜生活里可能飘荡着浪漫的音乐,但现在却充斥着孩子的哭闹声."     

古圣育贤"太太"何来

在中国历史上,有三位开国先君的夫人,她们都以母仪天下的德范,辅佐和教化了开万世太平的数位君王.她们就是周朝初期的"三太":太姜、太任和太姒.     

Gender in medicine: the views of first and fifth year medical students

This study of first and fifth year medical students found a general recognition among male and female students that gender affects future career choices and the ability to reach career goals. Females were seen as being disadvantaged both in terms of career choice and their ability to achieve career goals. These views are less abstract and more based upon the reality of personal experiences in clinical attachments among fifth year students. While both male and female students describe negative experiences of clinical training, female students were more likely to suffer discrimination because of their gender in certain specialties, such as surgery, and to be dissuaded from pursuing a career in that specialty. Despite the general awareness of the effects of gender in medicine this did not appear to have an effect upon personal career choice. However, some female students were considering career choices at an early stage in their career based on accommodating their future desire to have a family life. Over half of all male and female fifth year students reported that having time for their family was an important consideration in choosing a career.     

Choosing a career in general practice: the influence of medical schools

Summary. This paper reviews the literature on career choice to investigate the undergraduate influences on the preference of Australian graduates for a career in general practice. Although isolation of influencing factors is difficult, admission criteria and undergraduate curricula may influence career preference. As the institutional environment of medical schools is weighted towards scientific research and specialized medicine, medical students may be socialized into choosing non-generalist careers. Medical schools should consider broadening selection criteria and curriculum exposure to produce graduates with a broad range of career interests.     

Nature or nurture: the effect of undergraduate rural clinical rotations on pre-existent rural career choice likelihood as measured by the SOMERS Index

Objective: Do undergraduate rural clinical rotations increase the likelihood of medical students to choose a rural career once pre‐existent likelihood is accounted for? Design: A prospective, controlled quasi‐experiment using self‐paired scores on the SOMERS Index of rural career choice likelihood, before and after 3 years of clinical rotations in either mainly rural or mainly urban locations. Setting: Monash University medical school, Australia. Participants: Fifty‐eight undergraduate‐entry medical students (35% of the 2002 entry class). Main outcome measures: The SOMERS Index of rural career choice likelihood and its component indicators. Results: There was an overall decline in SOMERS Index score (22%) and in each of its components (12–41%). Graduating students who attended rural rotations were more likely to choose a rural career on graduation (difference in SOMERS score: 24.1 (95% CI, 15.0–33.3) P < 0.0001); however, at entry, students choosing rural rotations had an even greater SOMERS score (difference: 27.1 (95% CI, 18.2–36.1) P < 0.0001). Self‐paired pre–post reductions in likelihood were not affected by attending mainly rural or urban rotations, nor were there differences based on rural background alone or sex. Conclusions: While rural rotations are an important component of undergraduate medical training, it is the nature of the students choosing to study in rural locations rather than experiences during the course that is the greater influence on rural career choice. In order to improve the rural medical workforce crisis, medical schools should attract more students with pre‐existent likelihood to choose a rural career. The SOMERS Index was found to be a useful tool for this quantitative analysis.     

What happens to medical students who complete an honours year in public health and epidemiology?

BACKGROUND: Around one-third of medical students in the UK take an intercalated honours degree in addition to their basic undergraduate course. The honours year has been reported to have a major influence on subsequent career choice; honours students show greater interest in research and laboratory medicine careers and less in general practice and public health.1,2 AIMS: To examine the career choice of Nottingham medical students who completed an honours year in public health and epidemiology (including general practice). METHODS: Postal questionnaire and telephone follow-up of a cohort of 266 students who entered the honours year in Public Health and Epidemiology between 1973 and 1993. RESULTS: Career information was available on 203 students; 78% (195) of those are currently employed in medicine. 44% were working in general practice (expected 40-45%) and 8% in public health medicine (expected 2%). Overall 19% (expected 4-11%) had chosen academic careers including nine of the 15 choosing an academic career in public health. The majority (60%) reported that the honours year had influenced their career choice, while 55% reported that the year had increased their likelihood of choosing an academic career. CONCLUSIONS: The honours year does encourage entry into academic and research careers in general and the type of honours year department strongly influences the subsequent choice of specialty.     

Factors affecting future choice of specialty among first-year medical students of the University of the West Indies, Trinidad

BACKGROUND: This study was conducted to determine factors that influence career choice among 1st-year medical students. DESIGN AND METHODS: A cross-sectional survey of 170 1st-year medical students from the University of the West Indies, St Augustine Campus was undertaken with a questionnaire designed to assess their perceptions of careers in various specialties. Likert scales were used to quantify the reasons for their preferences. RESULTS: The response rate was 136/170 (80%). The age of respondents ranged from 16 to 36 years, mean 20.45, SD 2.88. Of the generic factors students considered important in their choice of a specialty, students ranked the ability to help patients the highest (rating of 1.44), along with the diagnosis and treatment of disease second (rating of 1.49); 38 (27.9%) cited medicine, 26 (19.1%) surgery, 13 (9.6%) paediatrics, 10 (7.4%) family practice and 4 (2.9%) psychiatry as their chosen career. Students begin their medical training with the view that a career in psychiatry is less attractive than other specialties surveyed. The average attractiveness was estimated as surgery 1.64, medicine, 1.81, paediatrics 1.95 and psychiatry 2.57. The differences between the averages were highly significant (F = 57.6, P < 0.001). CONCLUSION: The findings suggest that although 1st-year medical students rank the diagnosis and treatment of disease and the ability to help patients as the greatest influence in choosing a specialty, internal medicine was the most popular chosen career, while the surgical specialties were identified as the most attractive. Medical students have serious reservations about psychiatry as a career choice.     

Using a symbolic interactionist approach to role and identity to illuminate medical student avoidance of primary care

A symbolic interactionist approach is presented and analyzed in reference to helping solve the problem of medical students not choosing primary care practice for a career. The concepts of "Role" and "Identity" are examined in the social interaction context of pre-med and med students and the larger environment in the United States. Recommendations for application of these findings in selection of students and their training are included.     

Payback time: the associations of debt and income with medical student career choice

Medical Education 2012: 46 : 983–991 Context With impending health care reform in the USA, there is an imperative to increase the number of students choosing primary care (PC) careers. Research is needed to better understand the roles of economic factors in medical student career choice. The objective of this study was to examine the relationships among debt, income and career choice by comparing students planning PC careers with those aspiring to one of the 12 non‐PC fields in which median income exceeds US$300 000 (‘high‐paying non‐primary care’ [HPNPC]). Methods Surveys (response rate = 81%) were administered to Year 1 students scheduled to graduate between 1996 and 2012, and Year 4 students graduating between 1993 and 2010. Respondents were students at New York Medical College and East Carolina University’s Brody School of Medicine. Analyses focused on the 2674 Year 1 respondents choosing a PC (n = 1437, 54%) or HPNPC (n = 1237, 46%) career, and the 2307 Year 4 respondents intending to pursue PC (n = 992, 43%) or HPNPC (n = 1315, 57%). Longitudinal analyses examining changes in career goals during medical school were based on students who completed surveys in both Years 1 and 4. The outcome measures studied were self‐reported debt, anticipated income and self‐rated value placed on income. Results Relative to their PC counterparts, students intending to pursue HPNPC careers anticipated an average of US$24 904 (Year 4 students) or US$29 237 (Year 1 students) greater debt, placed a higher importance value on income, and anticipated earning an average of US$58 463 (Year 1 students) and US$89 909 (Year 4 students) more in annual income after graduation. Debt was associated with the value placed on income in the choice of career and the amount of future income anticipated. Students who valued income highly were especially inclined to switch from PC during medical school. The switch away from PC was associated with debt, as well as with a marked increase in anticipated income. Conclusions Debt and anticipated income are important concerns which may shape future supplies of PC doctors.     

Letter to the Editor: Barriers to effective asthma care in inner city general practice: Reply by the Authors

Objective: To monitor the future career preferences of medical students throughout their undergraduate years and into their postgraduate career, and to evaluate which factors may influence career choice intentions, and when this happens, over time. Design: Longitudinal study. Methods: Questionnaire to all Aberdeen, United Kingdom, Medical School entrants in 1996, and five annual follow-ups (four undergraduate, one postgraduate). Results: Response rates: year 1, 100%; year 2, 78%; year 3, 70%; year 4, 64%; year 5, 65%; pre-registration house officer (PRHO), 60%. Throughout the study, females were more positive about a career in general practice. General practice was the first choice for 13% of students in year 1; year 2, 9%; year 3, 22%; year 4, 24%; year 5, 27%; PRHO, 29%. Those choosing general practice were more likely than those choosing other specialties to be female, have their family home in Scotland, rate their academic abilities lower and their non-academic abilities as average, and have decided on their future career earlier. Reasons for general practice included: working in and being part of a community; continuity of patient contact; variety of illnesses and people encountered; undergraduate teaching experiences; dislike of or disillusionment with hospital medicine; and an increasing awareness of part-time opportunities.

Conclusion: As medical undergraduates progressed through the curriculum and became PRHOs, general practice became more popular as a career choice, particularly with females. This may be partly explained by the increased exposure to general practitioners and patients in the new community-based teaching programme and the increasing awareness of lifestyle advantages with the particular benefits of more regular hours and working part time.     

Nursing, pharmacy, or medicine? Disgust sensitivity predicts career interest among trainee health professionals

Given global demand on health workforces, understanding student enrollment motivations are critical. Prior studies have concentrated on variation in career and lifestyle values; the current work evaluated the importance of disgust sensitivity in the prediction of health career interests. We argue that emotional proclivities may be important and that disgust sensitivity may help explain differential student interest in nursing, pharmacy, or medical careers. 303 first year students attending a required course in human behavior provided consent before completing questionnaires assessing: (1) demographics, (2) career intentions/interests, (3) traditional determinants of career intention/interest, and (4) dispositional disgust sensitivity. As expected, disgust sensitivity varied across the three majors, with those targeting medical careers being less sensitive than those interested in either nursing or pharmacy. As importantly, even when controlling for demographics and traditional career determinants, analyses showed that greater disgust sensitivity was associated with reduced odds of intended enrolment in pharmacy versus medicine or nursing but did not predict the distinction between nursing and medicine. The impact of disgust sensitivity on career interest was substantial and equivalent to established predictors of career intention. Disgust sensitivity may represent an important factor impacting the specific choices students make within the health professions, particular when students are choosing between careers involving greater and lesser degrees of exposure to the normative elicitors of disgust.